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Packagehl7.fhir.us.davinci-cdex
Resource TypeBasic
IdBasic-cdex-data-consumer.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/davinci-ecdx/Requirements-cdex-data-consumer.html
URLhttp://hl7.org/fhir/us/davinci-cdex/Requirements/cdex-data-consumer
Version2.1.0
Statusdraft
Date2026-07-09T22:52:27+00:00
NameCDexDataConsumerRequirements
TitleCDex Data Consumer Requirements
Realmus
Authorityhl7
CopyrightUsed by permission of HL7 International all rights reserved Creative Commons License

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Requirements cdex-data-consumer

CONF-009SHALL

When signatures are required, the Data Consumer SHALL use a FHIR RESTful search instead of FHIR RESTful read. There is no CDex support for signatures on a FHIR RESTful read because it fetches a single instance of a resource instead of a Bundle.

Links:

CONF-011SHALL

The Da Vinci initiative supports this implementation guide. Da Vinci is a private effort to accelerate the adoption of Health Level Seven International Fast Healthcare Interoperability Resources (HL7® FHIR®) as the standard to support and integrate value-based care (VBC) data exchange across communities. This guide and implementers of it SHALL adhere to the HL7 Da Vinci Guiding Principles for exchanging patient health information.

Links:

CONF-014SHALL

Implementers SHALL read and adhere to the guidance for the following topics in the HRex Security and Privacy:<sup>[§][CONF-014]</sup>

  • Da Vinci's Guiding Principles
  • Statutes, Regulations
  • Clinical Safety Guidelines
  • FHIR Security and Implementation Guidance
  • Security/Privacy-Related Technologies, Including Explicit Consent and Security - Labels
  • Exchange Security
  • Additionally Protected Information
  • Security Contexts for Da Vinci IGs

Links:

CONF-015SHALL

User scopes SHALL be used as defined in SMART App Launch to restrict access to the relevant patients for a given Data Consumer.

Links:

CONF-016SHALL

Audit mechanisms SHALL be in place so that exchange mechanisms with or without human intervention can be subject to review/oversight.

Links:

CONF-018SHALL

The Data Consumer and Data Source SHALL use it [codes from the CDex Purpose of Use Value Set in the POU Task.input element.] to communicate the POU for the requested data when trading partner agreements require the POU to be exchanged.

Links:

CONF-022SHALL

[For managing large payloads in the $submit-attachment operation,] Servers SHALL document in their Capability Statement's CapabilityStatement.operation.documentation element or payer-supplied documentation:

  1. The payload endpoint size limits (e.g. 100MB )
  2. Whether they support the $submit-attachment's Final input parameter

Links:

CONF-023SHALL

When the [$submit-attachment] payload is too big, the Server SHALL use The HTTP 413 Content Too Large client error response status code (alternate status messages "Request Entity Too Large" or "Payload Too Large").

Links:

CONF-024SHALL

Servers SHALL document instructions for the Client when the [$submit-attachment] payload is (or is anticipated to be) too big. (for example, send a URL + authorization information, offload to external storage, split multiple files into multiple operations)

Links:

CONF-025SHALL

If the signatures fail verification when processing the $submit-attachment operation, the Data Source/Responder SHALL return an HTTP 400 Bad Request and an OperationOutcome declaring that the signature was invalid.

Links:

CONF-057SHALL

For CDex Task-based transactions, the CDex Task Data Request Profile SHALL be used by the Data Consumer to solicit information from a system.

Links:

CONF-058SHALL

When known, Task.reasonCode or Task.reasonReference SHALL reference the object that directly leads to the task - a particular claim, for example.

Links:

CONF-082SHALL

The Task.reasonReference DocumentReference.author is a Must Support element with four target profile and three Coverage profiles….Clients SHALL support all four profiles.

Links:

CONF-083SHALL

do not define the detailed POU, and the implementer SHALL supply an additional, alternate code. The resource fragment below shows their use:

Links:

CONF-086SHALL

Must Support elements are marked with the mustSupport flag and SHALL be interpreted [by the Task Source and Task Consumer] as follows in CONF-088, CONF-090, CONF-092, CONF-094, CONF-096.

Links:

CONF-087SHALL

Must Support elements are marked with the mustSupport flag and SHALL be interpreted [by the Task Source and Task Consumer] as follows in CONF-089, CONF-091, CONF-093, CONF-095, CONF-097.

Links:

CONF-088SHALL

[for Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required and the Task Source SHALL populatie the data element with a value unless {CONF-091].

Links:

CONF-089SHALL

[for Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required and the Task Source SHALL populatie the data element with a value unless {CONF-091].

Links:

CONF-090SHALL

[For Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required unless the profile references a dataAbsentReason (DAR) extension, then the Task Source SHALL use that extension to communicate the reason for missing data.

Links:

CONF-091SHALL

[For Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required unless the profile references a dataAbsentReason (DAR) extension, then the Task Source SHALL use that extension to communicate the reason for missing data.

Links:

CONF-092SHALL

[For Must Support elements marked with the mustSupport flag and ] the minimum cardinality of an element is equal to 0, the Task Source SHALL be capable of populating the data element when sharing Task compliant with a CDex profile.

Links:

CONF-093SHALL

[For Must Support elements marked with the mustSupport flag and ] the minimum cardinality of an element is equal to 0, the Task Source SHALL be capable of populating the data element when sharing Task compliant with a CDex profile.

Links:

CONF-094SHALL

[ For Must Support elements are marked with the mustSupport flag , the] ... Task Consumer SHALL be capable of processing Task instances containing the data elements without generating an error or causing the application to fail.

Links:

CONF-095SHALL

[ For Must Support elements are marked with the mustSupport flag , the] ... Task Consumer SHALL be capable of processing Task instances containing the data elements without generating an error or causing the application to fail.

Links:

CONF-098SHALL

For CDex attachment requests transactions, the Payer SHALL use the CDex Task Attachment Request Profile to solicit information from a Provider.

Links:

CONF-005SHALL NOT

The use of CDex SHALL NOT be considered compliant with any use case specific IG where CDex is not explicitly required as part of the supported exchanges.

Links:

CONF-001SHOULD

Systems ...SHOULD define what they support in their local capability statement in one or more of the following ways:

  1. (Preferred) Formally derived implementable profile from CDex Task Attachment Request Profile
  2. Document their systems' capabilities for requesting attachments in CapabilityStatement.rest.resource.documentation for the Task resource.
  3. (Preferred) Formal OperationDefinition derived from $submit-attachment
  4. Document their systems' capabilities for submitting attachments in CapabilityStatement.rest.documentation

Links:

CONF-002SHOULD

When submitting unsolicited attachments [using the $submit-attachment operation], the [Data Source/]Provider SHOULD populate Attachment.Code[parameter].

Links:

CONF-003SHOULD

[When submitting unsolicited attachments using the $submit-attachment operation] Servers SHOULD support Attachment.Content types beyond [the required types, ] DocumentReference and QuestionnaireResponse.

Links:

CONF-021SHOULD

The Payer SHOULD return an informational OperationOutcome with the HTTP accept response if the attachments can not be associated with a current claim or prior authorization and are being held for association with a future claim or prior authorization.

Links:

CONF-056SHOULD

Although the PAS guide leverages CDex, implementers SHOULD follow the Burden Reduction IGs to request additional information for prior authorization.

Links:

CONF-062SHOULD

Data Consumers SHOULD … [poll for Task updates] in an automated/background manner after 1 minute to return automated responses and no more than every 5 minutes for the first 30 minutes and no more frequently than once every hour after that.

Links:

CONF-078SHOULD

Systems SHOULD define what they support in their local capability statement in one or more of the following ways:

  1. (Preferred) Formally derived implementable profile from [CDex Task Data Request Profile] (StructureDefinition-cdex-task-data-request.html)
  2. Document their systems' capabilities for requesting attachments in CapabilityStatement.rest.resource.documentation for the Task resource.
  3. (Preferred) Formal OperationDefinition derived from $submit-attachment
  4. Document their systems' capabilities for submitting attachments in CapabilityStatement.rest.documentation

Links:

CONF-004SHOULD-NOT

CDex is not intended to supersede other Da Vinci guides, which focus on a particular use case and define how to share clinical information. However, CDex may be used to request clinical data from a provider when an alternative is needed to cover some aspects of an exchange. For example, suppose the provider's data release process does not allow the automatic request for information specified in a use case specific IG. In that case, CDex provides an asynchronous process that allows manual review before releasing the information. However, implementers SHOULD NOT use this transaction when there is a requirement for real-time response to facilitate patient care.

Links:

CONF-096SHOULD-NOT

[Data Consumers] ...SHOULD NOT reject instances that contain unexpected data elements if those elements are not modifier elements.

Links:

CONF-097SHOULD-NOT

[Data Consumers] ...SHOULD NOT reject instances that contain unexpected data elements if those elements are not modifier elements.

Links:

CONF-017MAY

Data Consumer and Data Source MAY communicate the POU for the requested data for each Task using codes from the CDex Purpose of Use Value Set in the POU Task.input element.

Links:

CONF-019SHALL

Organizational user access scopes are typically pre-negotiated and documented via business agreements. Data Sources SHALL translate these agreements into the appropriate SMART App Launch scopes.

Links:


Source1

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    },
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      "valueMarkdown": "This [Requirements](https://hl7.org/fhir/R5/requirements.html) resource lists all the CDex Data Consumer requirements defined in the narrative sections of this IG."
    },
    {
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.jurisdiction",
      "valueCodeableConcept": {
        "coding": [
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    },
    {
      "extension": [
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          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
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        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "When signatures are required, the Data Consumer **SHALL** use a [FHIR RESTful search](http://hl7.org/fhir/R4/http.html#search) instead of [FHIR RESTful read](http://hl7.org/fhir/R4/http.html#read). There is no CDex support for signatures on a FHIR RESTful read because it fetches a single instance of a resource instead of a Bundle."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "direct-query.html#data-sourceresponder-requirements"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-011"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "The [Da Vinci](http://www.hl7.org/about/davinci/index.cfm?ref=common) initiative supports this implementation guide. Da Vinci is a private effort to accelerate the adoption of Health Level Seven International Fast Healthcare Interoperability Resources (HL7® FHIR®) as the standard to support and integrate value-based care (VBC) data exchange across communities. This guide and implementers of it **SHALL** adhere to the [HL7 Da Vinci Guiding Principles](https://confluence.hl7.org/display/DVP/Da+Vinci+Clinical+Advisory+Council+Members?preview=/66940155/66942916/Guiding%20Principles%20for%20Da%20Vinci%20Implementation%20Guides.pdf) for exchanging patient health information."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "index.html#about-this-guide"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-014"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Implementers **SHALL** read and adhere to the guidance for the following topics in the [HRex Security and Privacy](http://hl7.org/fhir/us/davinci-hrex/1.2.0/security.html):<sup>[§][CONF-014]</sup>\n\n- Da Vinci's Guiding Principles\n- Statutes, Regulations\n- Clinical Safety Guidelines\n- FHIR Security and Implementation Guidance\n- Security/Privacy-Related Technologies, Including Explicit Consent and Security - Labels\n- Exchange Security\n- Additionally Protected Information\n- Security Contexts for Da Vinci IGs"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#da-vinci-hrex-security-and-privacy-requirements"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-015"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "User scopes **SHALL** be used as defined in [SMART App Launch](http://www.hl7.org/fhir/smart-app-launch/) to restrict access to the relevant patients for a given Data Consumer."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#general-considerations"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-016"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Audit mechanisms **SHALL** be in place so that exchange mechanisms *with or without human intervention* can be subject to review/oversight."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#general-considerations"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-018"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "The Data Consumer and Data Source **SHALL** use it [codes from the CDex Purpose of Use Value Set in the POU Task.input element.] to communicate the POU for the requested data when trading partner agreements require the POU to be exchanged."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#purpose-of-use"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-022"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[For managing large payloads in the $submit-attachment operation,] Servers **SHALL** document in their Capability Statement's `CapabilityStatement.operation.documentation` element or payer-supplied documentation:\n   1. The payload endpoint size limits (e.g. 100MB )\n   2. Whether they support the $submit-attachment's `Final` input parameter"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "sending-attachments.html#large-payloads"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-023"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "When the [$submit-attachment] payload is too big, the Server **SHALL** use The HTTP `413 Content Too Large` client error response status code (alternate status messages \"Request Entity Too Large\" or \"Payload Too Large\")."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "sending-attachments.html#large-payloads"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-024"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Servers **SHALL** document instructions for the Client when the  [$submit-attachment] payload is  (or is anticipated to be) too big. (for example, send a URL + authorization information, offload to external storage, split multiple files into multiple operations)"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "sending-attachments.html#large-payloads"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-025"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "If the signatures fail verification when processing the [`$submit-attachment`](OperationDefinition-submit-attachment.html) operation, the Data Source/Responder **SHALL** return an HTTP `400 Bad Request` *and* an OperationOutcome declaring that the signature was invalid."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "sending-attachments.html#the-payer-requirements"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-057"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "For CDex Task-based transactions, the [CDex Task Data Request Profile](StructureDefinition-cdex-task-data-request.html) **SHALL** be used by the Data Consumer to solicit information from a system."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-approach.html#the-task-resource"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-058"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "When known, `Task.reasonCode` or `Task.reasonReference` **SHALL** reference the object that directly leads to the task - a particular claim, for example."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-approach.html#task-reason"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-082"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "The `Task.reasonReference` `DocumentReference.author` is a  *Must Support*  element with four target profile and three Coverage profiles….Clients **SHALL** support all four profiles."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "StructureDefinition-cdex-task-data-request.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-083"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "do not define the detailed POU, and the implementer **SHALL** supply an additional, alternate code. The resource fragment below shows their use:"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "ValueSet-cdex-POU.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-086"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and **SHALL** be interpreted [by the Task Source and Task Consumer] as follows in CONF-088, CONF-090, CONF-092, CONF-094, CONF-096."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-087"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and **SHALL** be interpreted [by the Task Source and Task Consumer] as follows in CONF-089, CONF-091, CONF-093, CONF-095, CONF-097."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-088"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[for [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and ] the minimum cardinality of an element is greater than 0, the\n  element is *required* and the Task Source **SHALL** populatie the data element with a value unless {CONF-091]."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-089"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[for [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and ] the minimum cardinality of an element is greater than 0, the\n  element is *required* and the Task Source **SHALL** populatie the data element with a value unless {CONF-091]."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-090"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and ] the minimum cardinality of an element is greater than 0, the\n  element is *required* unless the profile references a dataAbsentReason (DAR) extension, then the Task Source **SHALL** use that extension to communicate the reason for missing data."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-091"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag and ] the minimum cardinality of an element is greater than 0, the\n  element is *required* unless the profile references a dataAbsentReason (DAR) extension, then the Task Source **SHALL** use that extension to communicate the reason for missing data."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-092"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements marked with the *mustSupport* flag and ] the minimum cardinality of an element is equal to 0, the Task Source **SHALL** be capable of populating the data element when sharing Task compliant with a CDex profile."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-093"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements marked with the *mustSupport* flag and ] the minimum cardinality of an element is equal to 0, the Task Source **SHALL** be capable of populating the data element when sharing Task compliant with a CDex profile."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-094"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[ For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag , the] ... Task Consumer **SHALL** be capable of processing Task instances  containing the data elements without generating an error or causing\n  the application to fail."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-095"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[ For [Must Support](http://hl7.org/fhir/R4/profiling.html#mustsupport) elements are marked with the *mustSupport* flag , the] ... Task Consumer **SHALL** be capable of processing Task instances  containing the data elements without generating an error or causing\n  the application to fail."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-098"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "For CDex attachment requests transactions, the Payer SHALL use the [CDex Task Attachment Request Profile](StructureDefinition-cdex-task-attachment-request.html) to solicit information from a Provider."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "requesting-attachments-code.html#cdex-attachment-request-profile"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot",
          "valueBoolean": true
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-005"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "The use of CDex **SHALL NOT** be considered compliant with any use case specific IG where CDex is not explicitly required as part of the supported exchanges."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "background.html#where-does-cdex-fit-in-the-da-vinci-project"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-001"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Systems ...**SHOULD** define what they support in their local capability statement in one or more of the following ways:\n\n1. (Preferred) Formally derived implementable profile from [CDex Task Attachment Request Profile](StructureDefinition-cdex-task-attachment-request.html)\n2. Document their systems' capabilities for requesting attachments in `CapabilityStatement.rest.resource.documentation` for the Task resource.\n3. (Preferred) Formal [OperationDefinition](http://hl7.org/fhir/R4/operationdefinition.html) derived from [`$submit-attachment`](OperationDefinition-submit-attachment.html)\n4. Document their systems' capabilities for submitting attachments in `CapabilityStatement.rest.documentation`"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html#introduction"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-002"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "When submitting unsolicited attachments [using the $submit-attachment operation], the [Data Source/]Provider  **SHOULD** populate `Attachment.Code`[parameter]."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html#submit-attachment-parameters-for-sending-attachments"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-003"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[When submitting unsolicited attachments using the $submit-attachment operation] Servers **SHOULD** support `Attachment.Content` types beyond  [the required types, ] `DocumentReference` and `QuestionnaireResponse`."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html#submit-attachment-parameters-for-sending-attachments"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-021"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "The Payer **SHOULD** return an informational OperationOutcome with the HTTP accept response if the attachments can not be associated with a *current* claim or prior authorization and are being held for association with a *future* claim or prior authorization."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "sending-attachments.html#technical-workflow"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-056"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": " Although the PAS guide leverages CDex, implementers **SHOULD** follow the Burden Reduction IGs to request additional information for prior authorization."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "solicited-unsolicited-attachments.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-062"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Data Consumers **SHOULD** … [poll for Task updates] in an automated/background manner after 1 minute to return automated responses and no more than every 5 minutes for the first 30 minutes and no more frequently than once every hour after that."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-approach.html#polling"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-078"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Systems **SHOULD** define what they support in their local capability statement in one or more of the following ways:\n\n1. (Preferred) Formally derived implementable profile from [CDex Task Data Request Profile]\n(StructureDefinition-cdex-task-data-request.html)\n1. Document their systems' capabilities for requesting attachments in `CapabilityStatement.rest.resource.documentation` for the Task resource.\n2. (Preferred) Formal [OperationDefinition](http://hl7.org/fhir/R4/operationdefinition.html) derived from [`$submit-attachment`](OperationDefinition-submit-attachment.html)\n3. Document their systems' capabilities for submitting attachments in `CapabilityStatement.rest.documentation`"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html#introduction"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-004"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD-NOT"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "CDex is not intended to supersede other Da Vinci guides, which focus on a particular use case and define how to share clinical information. However, CDex may be used to request clinical data from a provider when an alternative is needed to cover some aspects of an exchange. For example, suppose the provider's data release process does not allow the automatic request for information specified in a use case specific IG. In that case, CDex provides an asynchronous process that allows manual review before releasing the information. However, implementers **SHOULD NOT** use this transaction when there is a requirement for real-time response to facilitate patient care."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "background.html#where-does-cdex-fit-in-the-da-vinci-project"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-096"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD-NOT"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[Data Consumers] ...**SHOULD NOT** reject instances that contain unexpected data elements if those elements are not [modifier elements](http://hl7.org/fhir/R4/conformance-rules.html#isModifier)."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "attachments-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-097"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHOULD-NOT"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "[Data Consumers] ...**SHOULD NOT** reject instances that contain unexpected data elements if those elements are not [modifier elements](http://hl7.org/fhir/R4/conformance-rules.html#isModifier)."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "task-based-conformance.html"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-017"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "MAY"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Data Consumer and Data Source **MAY** communicate the POU for the requested data for each Task using codes from the [CDex Purpose of Use Value Set](ValueSet-cdex-POU.html) in the POU `Task.input` element. "
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#purpose-of-use"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.key",
          "valueId": "CONF-019"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.conformance",
          "valueCode": "SHALL"
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.requirement",
          "valueMarkdown": "Organizational user access scopes are typically pre-negotiated and documented via business agreements. Data Sources **SHALL** translate these agreements into the appropriate SMART App Launch scopes."
        },
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement.reference",
          "valueUrl": "security.html#general-considerations"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Requirements.statement"
    }
  ],
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.21.36.1"
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/fhir-types",
        "code": "Requirements"
      }
    ]
  }
}