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Source1

{
  "resourceType": "ConceptMap",
  "id": "R3-ClinicalImpression-element-map-to-R4",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"
          }
        ]
      }
    },
    {
      "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/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/xver/ConceptMap/R3-ClinicalImpression-element-map-to-R4",
  "version": "0.1.0",
  "name": "R3ClinicalImpressionElementMapToR4",
  "title": "Cross-version mapping for FHIR STU3 ClinicalImpression to FHIR R4 ClinicalImpression",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T16:03:23.2736426-05:00",
  "contact": [
    {
      "name": "FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "description": "This ConceptMap represents cross-version mappings for elements from a FHIR STU3 ClinicalImpression to FHIR R4.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "sourceCanonical": "http://hl7.org/fhir/3.0",
  "targetUri": "http://hl7.org/fhir/4.0",
  "group": [
    {
      "source": "http://hl7.org/fhir/StructureDefinition/ClinicalImpression",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/StructureDefinition/ClinicalImpression",
      "targetVersion": "4.0.1",
      "element": [
        {
          "code": "ClinicalImpression.meta",
          "display": "meta",
          "target": [
            {
              "code": "ClinicalImpression.meta",
              "display": "ClinicalImpression.meta",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.meta` is mapped to FHIR R4 element `ClinicalImpression.meta` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.implicitRules",
          "display": "implicitRules",
          "target": [
            {
              "code": "ClinicalImpression.implicitRules",
              "display": "ClinicalImpression.implicitRules",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.implicitRules` is mapped to FHIR R4 element `ClinicalImpression.implicitRules` as `Equivalent`.\nAsserting 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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation."
            }
          ]
        },
        {
          "code": "ClinicalImpression.language",
          "display": "language",
          "target": [
            {
              "code": "ClinicalImpression.language",
              "display": "ClinicalImpression.language",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.language` is mapped to FHIR R4 element `ClinicalImpression.language` as `Equivalent`.\nLanguage 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)."
            }
          ]
        },
        {
          "code": "ClinicalImpression.text",
          "display": "text",
          "target": [
            {
              "code": "ClinicalImpression.text",
              "display": "ClinicalImpression.text",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.text` is mapped to FHIR R4 element `ClinicalImpression.text` as `Equivalent`.\nContained 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 in formation is added later."
            }
          ]
        },
        {
          "code": "ClinicalImpression.contained",
          "display": "contained",
          "target": [
            {
              "code": "ClinicalImpression.contained",
              "display": "ClinicalImpression.contained",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.contained` is mapped to FHIR R4 element `ClinicalImpression.contained` as `Equivalent`.\nThis 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."
            }
          ]
        },
        {
          "code": "ClinicalImpression.identifier",
          "display": "identifier",
          "target": [
            {
              "code": "ClinicalImpression.identifier",
              "display": "ClinicalImpression.identifier",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.identifier` is mapped to FHIR R4 element `ClinicalImpression.identifier` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.status",
          "display": "status",
          "target": [
            {
              "code": "ClinicalImpression.status",
              "display": "ClinicalImpression.status",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.status` is mapped to FHIR R4 element `ClinicalImpression.status` as `Equivalent`.\nThis element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid."
            }
          ]
        },
        {
          "code": "ClinicalImpression.code",
          "display": "code",
          "target": [
            {
              "code": "ClinicalImpression.code",
              "display": "ClinicalImpression.code",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.code` is mapped to FHIR R4 element `ClinicalImpression.code` as `Equivalent`.\nThis is present as a place-holder only and may be removed based on feedback/work group opinion."
            }
          ]
        },
        {
          "code": "ClinicalImpression.description",
          "display": "description",
          "target": [
            {
              "code": "ClinicalImpression.description",
              "display": "ClinicalImpression.description",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.description` is mapped to FHIR R4 element `ClinicalImpression.description` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.subject",
          "display": "subject",
          "target": [
            {
              "code": "ClinicalImpression.subject",
              "display": "ClinicalImpression.subject",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.subject` is mapped to FHIR R4 element `ClinicalImpression.subject` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.context",
          "display": "context",
          "target": [
            {
              "code": "ClinicalImpression.encounter",
              "display": "ClinicalImpression.encounter",
              "equivalence": "wider",
              "comment": "Element `ClinicalImpression.context` is mapped to FHIR R4 element `ClinicalImpression.encounter` as `SourceIsBroaderThanTarget`.\nThe mappings for `ClinicalImpression.context` do not cover the following types based on type expansion: display, identifier, reference.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `ClinicalImpression.context` with unmapped reference targets: EpisodeOfCare."
            }
          ]
        },
        {
          "code": "ClinicalImpression.effective[x]",
          "display": "effective[x]",
          "target": [
            {
              "code": "ClinicalImpression.effective[x]",
              "display": "ClinicalImpression.effective[x]",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.effective[x]` is mapped to FHIR R4 element `ClinicalImpression.effective[x]` as `Equivalent`.\nThe target context `ClinicalImpression.effective[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ClinicalImpression`.\nThis SHOULD be accurate to at least the minute, though some assessments only have a known date."
            }
          ]
        },
        {
          "code": "ClinicalImpression.date",
          "display": "date",
          "target": [
            {
              "code": "ClinicalImpression.date",
              "display": "ClinicalImpression.date",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.date` is mapped to FHIR R4 element `ClinicalImpression.date` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.assessor",
          "display": "assessor",
          "target": [
            {
              "code": "ClinicalImpression.assessor",
              "display": "ClinicalImpression.assessor",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.assessor` is mapped to FHIR R4 element `ClinicalImpression.assessor` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.previous",
          "display": "previous",
          "target": [
            {
              "code": "ClinicalImpression.previous",
              "display": "ClinicalImpression.previous",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.previous` is mapped to FHIR R4 element `ClinicalImpression.previous` as `Equivalent`.\nIt is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved)."
            }
          ]
        },
        {
          "code": "ClinicalImpression.problem",
          "display": "problem",
          "target": [
            {
              "code": "ClinicalImpression.problem",
              "display": "ClinicalImpression.problem",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.problem` is mapped to FHIR R4 element `ClinicalImpression.problem` as `Equivalent`.\ne.g. The patient is a pregnant, and cardiac congestive failure, ‎Adenocarcinoma, and is allergic to penicillin."
            }
          ]
        },
        {
          "code": "ClinicalImpression.investigation",
          "display": "investigation",
          "target": [
            {
              "code": "ClinicalImpression.investigation",
              "display": "ClinicalImpression.investigation",
              "equivalence": "wider",
              "comment": "Element `ClinicalImpression.investigation` is mapped to FHIR R4 element `ClinicalImpression.investigation` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.investigation.code",
          "display": "code",
          "target": [
            {
              "code": "ClinicalImpression.investigation.code",
              "display": "ClinicalImpression.investigation.code",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.investigation.code` is mapped to FHIR R4 element `ClinicalImpression.investigation.code` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.investigation.item",
          "display": "item",
          "target": [
            {
              "code": "ClinicalImpression.investigation.item",
              "display": "ClinicalImpression.investigation.item",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.investigation.item` is mapped to FHIR R4 element `ClinicalImpression.investigation.item` as `Equivalent`.\nMost investigations are observations of one kind of or another but some other specific types of data collection resources can also be used."
            }
          ]
        },
        {
          "code": "ClinicalImpression.protocol",
          "display": "protocol",
          "target": [
            {
              "code": "ClinicalImpression.protocol",
              "display": "ClinicalImpression.protocol",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.protocol` is mapped to FHIR R4 element `ClinicalImpression.protocol` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.summary",
          "display": "summary",
          "target": [
            {
              "code": "ClinicalImpression.summary",
              "display": "ClinicalImpression.summary",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.summary` is mapped to FHIR R4 element `ClinicalImpression.summary` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.finding",
          "display": "finding",
          "target": [
            {
              "code": "ClinicalImpression.finding",
              "display": "ClinicalImpression.finding",
              "equivalence": "wider",
              "comment": "Element `ClinicalImpression.finding` is mapped to FHIR R4 element `ClinicalImpression.finding` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.finding.item[x]",
          "display": "item[x]",
          "target": [
            {
              "code": "ClinicalImpression.finding.itemCodeableConcept",
              "display": "ClinicalImpression.finding.itemCodeableConcept",
              "equivalence": "relatedto",
              "comment": "Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.\nElement `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`."
            },
            {
              "code": "ClinicalImpression.finding.itemReference",
              "display": "ClinicalImpression.finding.itemReference",
              "equivalence": "relatedto",
              "comment": "Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.\nElement `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.finding.basis",
          "display": "basis",
          "target": [
            {
              "code": "ClinicalImpression.finding.basis",
              "display": "ClinicalImpression.finding.basis",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.finding.basis` is mapped to FHIR R4 element `ClinicalImpression.finding.basis` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.prognosisCodeableConcept",
          "display": "prognosisCodeableConcept",
          "target": [
            {
              "code": "ClinicalImpression.prognosisCodeableConcept",
              "display": "ClinicalImpression.prognosisCodeableConcept",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.prognosisCodeableConcept` is mapped to FHIR R4 element `ClinicalImpression.prognosisCodeableConcept` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.prognosisReference",
          "display": "prognosisReference",
          "target": [
            {
              "code": "ClinicalImpression.prognosisReference",
              "display": "ClinicalImpression.prognosisReference",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.prognosisReference` is mapped to FHIR R4 element `ClinicalImpression.prognosisReference` as `Equivalent`."
            }
          ]
        },
        {
          "code": "ClinicalImpression.note",
          "display": "note",
          "target": [
            {
              "code": "ClinicalImpression.note",
              "display": "ClinicalImpression.note",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.note` is mapped to FHIR R4 element `ClinicalImpression.note` as `Equivalent`.\nDon't use this element for content that should more properly appear as one of the specific elements of the impression."
            }
          ]
        }
      ]
    },
    {
      "source": "http://hl7.org/fhir/StructureDefinition/ClinicalImpression",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/3.0/StructureDefinition/extension-ClinicalImpression.action",
      "targetVersion": "0.1.0",
      "element": [
        {
          "code": "ClinicalImpression.action",
          "display": "action",
          "target": [
            {
              "code": "Extension",
              "equivalence": "equivalent",
              "comment": "Element `ClinicalImpression.action` has a context of ClinicalImpression based on following the parent source element upwards and mapping to `ClinicalImpression`.\nElement `ClinicalImpression.action` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nActions recommended as a result of the impression should not be captured using the 'action' element."
            }
          ]
        }
      ]
    }
  ]
}