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Packagehl7.fhir.us.davinci-pdex
Resource TypeStructureDefinition
IdStructureDefinition-provider-treatment-relationship-consent.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/davinci-epdx/StructureDefinition-provider-treatment-relationship-consent.html
URLhttp://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent
Version2.1.1
Statusactive
Date2024-12-16T00:00:00Z
NameProviderTreatmentAttestation
TitleProvider Attestation to Treatment Relationship
Realmus
Authorityhl7
DescriptionEnables a practitioner, facility, or organization to attest to a treatment relationship with a patient. This profile documents that a healthcare provider has an active treatment relationship with the patient for the purposes of care delivery, coordination, and related activities. This profile is used in the Provider-Member-Match operation to enable providers to assert treatment relationships with patients for bulk data access.
CopyrightUsed by permission of HL7 International, all rights reserved Creative Commons License
TypeConsent
Kindresource

Resources that use this resource

StructureDefinition
provider-parameters-multi-member-match-bundle-inProvider $multi-member-match Request

Resources that this resource uses

ValueSet
attestation-provision-type-valuesetTreatment Attestation Provision Type
attestation-status-valuesetTreatment Attestation Status
v3-PurposeOfUsePurposeOfUse

Narrative

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

Generated Narrative: StructureDefinition provider-treatment-relationship-consent

NameFlagsCard.TypeDescription & Constraintsdoco
.. Consent Consent
... status S1..1codeStatus of the treatment relationship attestation
Binding: Treatment Attestation Status (required)
... scope S1..1CodeableConceptTreatment relationship scope
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (Complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: treatment
... category S1..*CodeableConceptClassification of consent (e.g., treatment relationship, attestation)
Binding: ConsentCategoryCodes (extensible)
... patient S1..1Reference(Patient)Patient who is the subject of the treatment relationship
... dateTime S1..1dateTimeDate/time when treatment relationship attestation was recorded
... performer S1..*Reference(Practitioner | Organization | PractitionerRole)Practitioner, facility, or organization attesting to treatment relationship
... organization S0..1Reference(Organization)Organization responsible for the treatment relationship
... source[x] S0..1Attachment, Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)Source of the attestation
... policy S0..*BackboneElementPolicies or regulations governing the treatment relationship
... verification S0..*BackboneElementVerification of the treatment relationship attestation
.... verified S1..1booleanWhether the attestation has been verified
.... verifiedWith S0..1Reference(Patient | RelatedPerson)Who verified the attestation
.... verificationDate S0..1dateTimeWhen the attestation was verified
... provision S0..1BackboneElementDetails of the treatment relationship
.... type S0..1codeWhether this is a permission (permit) or denial
Binding: Treatment Attestation Provision Type (required)
.... period S0..1PeriodTime period for the treatment relationship
..... start S0..1dateTimeStart date of treatment relationship
.... actor S0..*BackboneElementActors involved in the treatment relationship
..... role S1..1CodeableConceptHow the actor is involved
..... reference S1..1Reference(Practitioner | Organization | PractitionerRole | CareTeam)Resource for the actor (or group, by role)
.... purpose S0..*CodingPurpose of accessing patient information
Binding: PurposeOfUse (extensible)

doco Documentation for this format

Source1

{
  "resourceType": "StructureDefinition",
  "id": "provider-treatment-relationship-consent",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 2,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent",
  "version": "2.1.1",
  "name": "ProviderTreatmentAttestation",
  "title": "Provider Attestation to Treatment Relationship",
  "status": "active",
  "experimental": false,
  "date": "2024-12-16T00:00:00Z",
  "publisher": "HL7 International / Financial Management",
  "contact": [
    {
      "name": "HL7 International / Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system": "email",
          "value": "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name": "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom": [
        {
          "system": "email",
          "value": "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name": "HL7 International - Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "Enables a practitioner, facility, or organization to attest to a treatment relationship with a patient. This profile documents that a healthcare provider has an active treatment relationship with the patient for the purposes of care delivery, coordination, and related activities. This profile is used in the Provider-Member-Match operation to enable providers to assert treatment relationships with patients for bulk data access.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US",
          "display": "United States of America"
        }
      ]
    }
  ],
  "copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Consent",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Consent",
  "derivation": "constraint",
  "snapshot": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
        "valueString": "4.0.1"
      }
    ],
    "element": [
      {
        "id": "Consent",
        "path": "Consent",
        "short": "A healthcare consumer's  choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time",
        "definition": "A record of a healthcare consumer’s  choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.",
        "comment": "Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent",
          "min": 0,
          "max": "*"
        },
        "constraint": [
          {
            "key": "dom-2",
            "severity": "error",
            "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression": "contained.contained.empty()",
            "xpath": "not(parent::f:contained and f:contained)",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-3",
            "severity": "error",
            "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",
            "expression": "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()",
            "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-4",
            "severity": "error",
            "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-5",
            "severity": "error",
            "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
            "expression": "contained.meta.security.empty()",
            "xpath": "not(exists(f:contained/*/f:meta/f:security))",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                "valueBoolean": true
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                "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."
              }
            ],
            "key": "dom-6",
            "severity": "warning",
            "human": "A resource should have narrative for robust management",
            "expression": "text.`div`.exists()",
            "xpath": "exists(f:text/h:div)",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "ppc-1",
            "severity": "error",
            "human": "Either a Policy or PolicyRule",
            "expression": "policy.exists() or policyRule.exists()",
            "xpath": "exists(f:policy) or exists(f:policyRule)",
            "source": "http://hl7.org/fhir/StructureDefinition/Consent"
          },
          {
            "key": "ppc-2",
            "severity": "error",
            "human": "IF Scope=privacy, there must be a patient",
            "expression": "patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()",
            "xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='patient-privacy'])))",
            "source": "http://hl7.org/fhir/StructureDefinition/Consent"
          },
          {
            "key": "ppc-3",
            "severity": "error",
            "human": "IF Scope=research, there must be a patient",
            "expression": "patient.exists() or scope.coding.where(system='something' and code='research').exists().not()",
            "xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='research'])))",
            "source": "http://hl7.org/fhir/StructureDefinition/Consent"
          },
          {
            "key": "ppc-4",
            "severity": "error",
            "human": "IF Scope=adr, there must be a patient",
            "expression": "patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()",
            "xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='adr'])))",
            "source": "http://hl7.org/fhir/StructureDefinition/Consent"
          },
          {
            "key": "ppc-5",
            "severity": "error",
            "human": "IF Scope=treatment, there must be a patient",
            "expression": "patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()",
            "xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='treatment'])))",
            "source": "http://hl7.org/fhir/StructureDefinition/Consent"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "Entity. Role, or Act"
          },
          {
            "identity": "workflow",
            "map": "Event"
          },
          {
            "identity": "v2",
            "map": "CON"
          },
          {
            "identity": "rim",
            "map": "FinancialConsent"
          }
        ]
      },
      {
        "id": "Consent.id",
        "path": "Consent.id",
        "short": "Logical id of this artifact",
        "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "id"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.meta",
        "path": "Consent.meta",
        "short": "Metadata about the resource",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.meta",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Meta"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.implicitRules",
        "path": "Consent.implicitRules",
        "short": "A set of rules under which this content was created",
        "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.",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.implicitRules",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": true,
        "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",
        "isSummary": true
      },
      {
        "id": "Consent.language",
        "path": "Consent.language",
        "short": "Language of the resource content",
        "definition": "The base language in which the resource is written.",
        "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).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.language",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
              "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "Language"
            }
          ],
          "strength": "preferred",
          "description": "A human language.",
          "valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1"
        }
      },
      {
        "id": "Consent.text",
        "path": "Consent.text",
        "short": "Text summary of the resource, for human interpretation",
        "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.",
        "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.",
        "alias": [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "DomainResource.text",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Narrative"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "Act.text?"
          }
        ]
      },
      {
        "id": "Consent.contained",
        "path": "Consent.contained",
        "short": "Contained, inline Resources",
        "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.",
        "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.",
        "alias": [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.contained",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Resource"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.extension",
        "path": "Consent.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.modifierExtension",
        "path": "Consent.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.identifier",
        "path": "Consent.identifier",
        "short": "Identifier for this record (external references)",
        "definition": "Unique identifier for this copy of the Consent Statement.",
        "comment": "This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.identifier",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueIdentifier": {
              "system": "http://acme.org/identifier/local/eCMS",
              "value": "Local eCMS identifier"
            }
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.identifier"
          },
          {
            "identity": "w5",
            "map": "FiveWs.identifier"
          },
          {
            "identity": "rim",
            "map": ".id"
          }
        ]
      },
      {
        "id": "Consent.status",
        "path": "Consent.status",
        "short": "Status of the treatment relationship attestation",
        "definition": "Indicates whether this treatment relationship attestation is active, inactive, or has been entered in error",
        "comment": "This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.",
        "requirements": "The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.status",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": true,
        "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",
        "isSummary": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-status-valueset"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.status"
          },
          {
            "identity": "w5",
            "map": "FiveWs.status"
          },
          {
            "identity": "v2",
            "map": "HL7 Table 0498 - Consent Status"
          },
          {
            "identity": "rim",
            "map": ".statusCode"
          }
        ]
      },
      {
        "id": "Consent.scope",
        "path": "Consent.scope",
        "short": "Treatment relationship scope",
        "definition": "Fixed to 'treatment' to indicate this consent represents a treatment relationship",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.scope",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/consentscope",
              "code": "treatment"
            }
          ]
        },
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": true,
        "isModifierReason": "Allows changes to codes based on scope selection",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentScope"
            }
          ],
          "strength": "extensible",
          "description": "The four anticipated uses for the Consent Resource.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-scope|4.0.1"
        }
      },
      {
        "id": "Consent.category",
        "path": "Consent.category",
        "short": "Classification of consent (e.g., treatment relationship, attestation)",
        "definition": "Classification of the type of consent. Should include codes indicating treatment relationship and attestation",
        "min": 1,
        "max": "*",
        "base": {
          "path": "Consent.category",
          "min": 1,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-category"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.code"
          },
          {
            "identity": "w5",
            "map": "FiveWs.class"
          },
          {
            "identity": "v2",
            "map": "HL7 Table 0497 - Consent Type"
          },
          {
            "identity": "rim",
            "map": "CNTRCT"
          }
        ]
      },
      {
        "id": "Consent.patient",
        "path": "Consent.patient",
        "short": "Patient who is the subject of the treatment relationship",
        "definition": "Reference to the patient for whom the treatment relationship is being attested",
        "comment": "Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.patient",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.subject"
          },
          {
            "identity": "w5",
            "map": "FiveWs.subject[x]"
          },
          {
            "identity": "rim",
            "map": "Role"
          },
          {
            "identity": "w5",
            "map": "FiveWs.subject"
          }
        ]
      },
      {
        "id": "Consent.dateTime",
        "path": "Consent.dateTime",
        "short": "Date/time when treatment relationship attestation was recorded",
        "definition": "When this treatment relationship attestation was recorded or last updated",
        "comment": "This is not the time of the original consent, but the time that this statement was made or derived.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.dateTime",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.occurrence[x]"
          },
          {
            "identity": "w5",
            "map": "FiveWs.recorded"
          },
          {
            "identity": "v2",
            "map": "Field 13/ Consent Decision Date"
          },
          {
            "identity": "rim",
            "map": "FinancialConsent effectiveTime"
          }
        ]
      },
      {
        "id": "Consent.performer",
        "path": "Consent.performer",
        "short": "Practitioner, facility, or organization attesting to treatment relationship",
        "definition": "The healthcare provider (practitioner, organization, or facility) attesting that they have a treatment relationship with the patient",
        "comment": "Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.",
        "alias": [
          "consentor"
        ],
        "min": 1,
        "max": "*",
        "base": {
          "path": "Consent.performer",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.performer"
          },
          {
            "identity": "w5",
            "map": "FiveWs.actor"
          },
          {
            "identity": "v2",
            "map": "Field 24/ ConsenterID"
          }
        ]
      },
      {
        "id": "Consent.organization",
        "path": "Consent.organization",
        "short": "Organization responsible for the treatment relationship",
        "definition": "The healthcare organization under which this treatment relationship exists",
        "alias": [
          "custodian"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.organization",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.performer"
          },
          {
            "identity": "w5",
            "map": "FiveWs.witness"
          }
        ]
      },
      {
        "id": "Consent.source[x]",
        "path": "Consent.source[x]",
        "short": "Source of the attestation",
        "definition": "Reference to the source document, system, or person who provided the attestation",
        "comment": "The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.source[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Attachment"
          },
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Consent|4.0.1",
              "http://hl7.org/fhir/StructureDefinition/DocumentReference|4.0.1",
              "http://hl7.org/fhir/StructureDefinition/Contract|4.0.1",
              "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "Field 19 Informational Material Supplied Indicator"
          }
        ]
      },
      {
        "id": "Consent.policy",
        "path": "Consent.policy",
        "short": "Policies or regulations governing the treatment relationship",
        "definition": "References to applicable policies, regulations, or legal frameworks governing treatment relationships",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.policy",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.policy.id",
        "path": "Consent.policy.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.policy.extension",
        "path": "Consent.policy.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.policy.modifierExtension",
        "path": "Consent.policy.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.policy.authority",
        "path": "Consent.policy.authority",
        "short": "Enforcement source for policy",
        "definition": "Entity or Organization having regulatory jurisdiction or accountability for  enforcing policies pertaining to Consent Directives.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.policy.authority",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "condition": [
          "ppc-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.policy.uri",
        "path": "Consent.policy.uri",
        "short": "Specific policy covered by this consent",
        "definition": "The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.",
        "comment": "This element is for discoverability / documentation and does not modify or qualify the policy rules.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.policy.uri",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "condition": [
          "ppc-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.policyRule",
        "path": "Consent.policyRule",
        "short": "Regulation that this consents to",
        "definition": "A reference to the specific base computable regulation or policy.",
        "comment": "If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.",
        "requirements": "Might be a unique identifier of a policy set in XACML, or other rules engine.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.policyRule",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "condition": [
          "ppc-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentPolicyRule"
            }
          ],
          "strength": "extensible",
          "description": "Regulatory policy examples.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-policy|4.0.1"
        }
      },
      {
        "id": "Consent.verification",
        "path": "Consent.verification",
        "short": "Verification of the treatment relationship attestation",
        "definition": "Information about verification of the treatment relationship attestation",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.verification",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.verification.id",
        "path": "Consent.verification.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.verification.extension",
        "path": "Consent.verification.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.verification.modifierExtension",
        "path": "Consent.verification.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.verification.verified",
        "path": "Consent.verification.verified",
        "short": "Whether the attestation has been verified",
        "definition": "Has the instruction been verified.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.verification.verified",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.verification.verifiedWith",
        "path": "Consent.verification.verifiedWith",
        "short": "Who verified the attestation",
        "definition": "Who verified the instruction (Patient, Relative or other Authorized Person).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.verification.verifiedWith",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.verification.verificationDate",
        "path": "Consent.verification.verificationDate",
        "short": "When the attestation was verified",
        "definition": "Date verification was collected.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.verification.verificationDate",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.provision",
        "path": "Consent.provision",
        "short": "Details of the treatment relationship",
        "definition": "Detailed provisions about the scope, purpose, and period of the treatment relationship",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.provision",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.provision.id",
        "path": "Consent.provision.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.extension",
        "path": "Consent.provision.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.modifierExtension",
        "path": "Consent.provision.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.provision.type",
        "path": "Consent.provision.type",
        "short": "Whether this is a permission (permit) or denial",
        "definition": "For treatment relationships, this should typically be 'permit' indicating an active relationship",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.provision.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-provision-type-valueset"
        }
      },
      {
        "id": "Consent.provision.period",
        "path": "Consent.provision.period",
        "short": "Time period for the treatment relationship",
        "definition": "The time period during which the treatment relationship is valid or was active",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.provision.period",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.provision.period.id",
        "path": "Consent.provision.period.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.period.extension",
        "path": "Consent.provision.period.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.period.start",
        "path": "Consent.provision.period.start",
        "short": "Start date of treatment relationship",
        "definition": "The start of the period. The boundary is inclusive.",
        "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Period.start",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "condition": [
          "per-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "DR.1"
          },
          {
            "identity": "rim",
            "map": "./low"
          }
        ]
      },
      {
        "id": "Consent.provision.period.end",
        "path": "Consent.provision.period.end",
        "short": "End time with inclusive boundary, if not ongoing",
        "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
        "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Period.end",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
        "condition": [
          "per-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "DR.2"
          },
          {
            "identity": "rim",
            "map": "./high"
          }
        ]
      },
      {
        "id": "Consent.provision.actor",
        "path": "Consent.provision.actor",
        "short": "Actors involved in the treatment relationship",
        "definition": "Specific practitioners, organizations, or facilities involved in providing care under this treatment relationship",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.actor",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "meaningWhenMissing": "There is no specific actor associated with the exception",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.provision.actor.id",
        "path": "Consent.provision.actor.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.actor.extension",
        "path": "Consent.provision.actor.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.actor.modifierExtension",
        "path": "Consent.provision.actor.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.provision.actor.role",
        "path": "Consent.provision.actor.role",
        "short": "How the actor is involved",
        "definition": "How the individual is involved in the resources content that is described in the exception.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.provision.actor.role",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentActorRole"
            }
          ],
          "strength": "extensible",
          "description": "How an actor is involved in the consent considerations.",
          "valueSet": "http://hl7.org/fhir/ValueSet/security-role-type|4.0.1"
        }
      },
      {
        "id": "Consent.provision.actor.reference",
        "path": "Consent.provision.actor.reference",
        "short": "Resource for the actor (or group, by role)",
        "definition": "The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.provision.actor.reference",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/CareTeam"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false
      },
      {
        "id": "Consent.provision.action",
        "path": "Consent.provision.action",
        "short": "Actions controlled by this rule",
        "definition": "Actions controlled by this Rule.",
        "comment": "Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.action",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "meaningWhenMissing": "all actions",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentAction"
            }
          ],
          "strength": "example",
          "description": "Detailed codes for the consent action.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-action|4.0.1"
        }
      },
      {
        "id": "Consent.provision.securityLabel",
        "path": "Consent.provision.securityLabel",
        "short": "Security Labels that define affected resources",
        "definition": "A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.",
        "comment": "If the consent specifies a security label of \"R\" then it applies to all resources that are labeled \"R\" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.securityLabel",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Coding"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "SecurityLabels"
            }
          ],
          "strength": "extensible",
          "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
          "valueSet": "http://hl7.org/fhir/ValueSet/security-labels|4.0.1"
        }
      },
      {
        "id": "Consent.provision.purpose",
        "path": "Consent.provision.purpose",
        "short": "Purpose of accessing patient information",
        "definition": "The purpose(s) for which the treatment relationship allows access to patient information (e.g., treatment, care coordination, quality improvement)",
        "comment": "When the purpose of use tag is on the data, access request purpose of use shall not conflict.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.purpose",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Coding"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "http://terminology.hl7.org/ValueSet/v3-PurposeOfUse"
        }
      },
      {
        "id": "Consent.provision.class",
        "path": "Consent.provision.class",
        "short": "e.g. Resource Type, Profile, CDA, etc.",
        "definition": "The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.",
        "comment": "Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.class",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Coding"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentContentClass"
            }
          ],
          "strength": "extensible",
          "description": "The class (type) of information a consent rule covers.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-content-class|4.0.1"
        }
      },
      {
        "id": "Consent.provision.code",
        "path": "Consent.provision.code",
        "short": "e.g. LOINC or SNOMED CT code, etc. in the content",
        "definition": "If this code is found in an instance, then the rule applies.",
        "comment": "Typical use of this is a Document code with class = CDA.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.code",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentContentCode"
            }
          ],
          "strength": "example",
          "description": "If this code is found in an instance, then the exception applies.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-content-code|4.0.1"
        }
      },
      {
        "id": "Consent.provision.dataPeriod",
        "path": "Consent.provision.dataPeriod",
        "short": "Timeframe for data controlled by this rule",
        "definition": "Clinical or Operational Relevant period of time that bounds the data controlled by this rule.",
        "comment": "This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Consent.provision.dataPeriod",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.provision.data",
        "path": "Consent.provision.data",
        "short": "Data controlled by this rule",
        "definition": "The resources controlled by this rule if specific resources are referenced.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.data",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "meaningWhenMissing": "all data",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "Role"
          }
        ]
      },
      {
        "id": "Consent.provision.data.id",
        "path": "Consent.provision.data.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.data.extension",
        "path": "Consent.provision.data.extension",
        "short": "Additional content defined by implementations",
        "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.",
        "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Consent.provision.data.modifierExtension",
        "path": "Consent.provision.data.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "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.",
        "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).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Consent.provision.data.meaning",
        "path": "Consent.provision.data.meaning",
        "short": "instance | related | dependents | authoredby",
        "definition": "How the resource reference is interpreted when testing consent restrictions.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.provision.data.meaning",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ConsentDataMeaning"
            }
          ],
          "strength": "required",
          "description": "How a resource reference is interpreted when testing consent restrictions.",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1"
        }
      },
      {
        "id": "Consent.provision.data.reference",
        "path": "Consent.provision.data.reference",
        "short": "The actual data reference",
        "definition": "A reference to a specific resource that defines which resources are covered by this consent.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Consent.provision.data.reference",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Consent.provision.provision",
        "path": "Consent.provision.provision",
        "short": "Nested Exception Rules",
        "definition": "Rules which provide exceptions to the base rule or subrules.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Consent.provision.provision",
          "min": 0,
          "max": "*"
        },
        "contentReference": "http://hl7.org/fhir/StructureDefinition/Consent#Consent.provision",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Consent.status",
        "path": "Consent.status",
        "short": "Status of the treatment relationship attestation",
        "definition": "Indicates whether this treatment relationship attestation is active, inactive, or has been entered in error",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-status-valueset"
        }
      },
      {
        "id": "Consent.scope",
        "path": "Consent.scope",
        "short": "Treatment relationship scope",
        "definition": "Fixed to 'treatment' to indicate this consent represents a treatment relationship",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/consentscope",
              "code": "treatment"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Consent.category",
        "path": "Consent.category",
        "short": "Classification of consent (e.g., treatment relationship, attestation)",
        "definition": "Classification of the type of consent. Should include codes indicating treatment relationship and attestation",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-category"
        }
      },
      {
        "id": "Consent.patient",
        "path": "Consent.patient",
        "short": "Patient who is the subject of the treatment relationship",
        "definition": "Reference to the patient for whom the treatment relationship is being attested",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.dateTime",
        "path": "Consent.dateTime",
        "short": "Date/time when treatment relationship attestation was recorded",
        "definition": "When this treatment relationship attestation was recorded or last updated",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.performer",
        "path": "Consent.performer",
        "short": "Practitioner, facility, or organization attesting to treatment relationship",
        "definition": "The healthcare provider (practitioner, organization, or facility) attesting that they have a treatment relationship with the patient",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.organization",
        "path": "Consent.organization",
        "short": "Organization responsible for the treatment relationship",
        "definition": "The healthcare organization under which this treatment relationship exists",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.source[x]",
        "path": "Consent.source[x]",
        "short": "Source of the attestation",
        "definition": "Reference to the source document, system, or person who provided the attestation",
        "mustSupport": true
      },
      {
        "id": "Consent.policy",
        "path": "Consent.policy",
        "short": "Policies or regulations governing the treatment relationship",
        "definition": "References to applicable policies, regulations, or legal frameworks governing treatment relationships",
        "mustSupport": true
      },
      {
        "id": "Consent.verification",
        "path": "Consent.verification",
        "short": "Verification of the treatment relationship attestation",
        "definition": "Information about verification of the treatment relationship attestation",
        "mustSupport": true
      },
      {
        "id": "Consent.verification.verified",
        "path": "Consent.verification.verified",
        "short": "Whether the attestation has been verified",
        "mustSupport": true
      },
      {
        "id": "Consent.verification.verifiedWith",
        "path": "Consent.verification.verifiedWith",
        "short": "Who verified the attestation",
        "mustSupport": true
      },
      {
        "id": "Consent.verification.verificationDate",
        "path": "Consent.verification.verificationDate",
        "short": "When the attestation was verified",
        "mustSupport": true
      },
      {
        "id": "Consent.provision",
        "path": "Consent.provision",
        "short": "Details of the treatment relationship",
        "definition": "Detailed provisions about the scope, purpose, and period of the treatment relationship",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.type",
        "path": "Consent.provision.type",
        "short": "Whether this is a permission (permit) or denial",
        "definition": "For treatment relationships, this should typically be 'permit' indicating an active relationship",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-provision-type-valueset"
        }
      },
      {
        "id": "Consent.provision.period",
        "path": "Consent.provision.period",
        "short": "Time period for the treatment relationship",
        "definition": "The time period during which the treatment relationship is valid or was active",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.period.start",
        "path": "Consent.provision.period.start",
        "short": "Start date of treatment relationship",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor",
        "path": "Consent.provision.actor",
        "short": "Actors involved in the treatment relationship",
        "definition": "Specific practitioners, organizations, or facilities involved in providing care under this treatment relationship",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role",
        "path": "Consent.provision.actor.role",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.reference",
        "path": "Consent.provision.actor.reference",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/CareTeam"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.provision.purpose",
        "path": "Consent.provision.purpose",
        "short": "Purpose of accessing patient information",
        "definition": "The purpose(s) for which the treatment relationship allows access to patient information (e.g., treatment, care coordination, quality improvement)",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "http://terminology.hl7.org/ValueSet/v3-PurposeOfUse"
        }
      }
    ]
  }
}