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{
  "resourceType": "ConceptMap",
  "id": "R3-DocumentReference-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-DocumentReference-element-map-to-R4",
  "version": "0.1.0",
  "name": "R3DocumentReferenceElementMapToR4",
  "title": "Cross-version mapping for FHIR STU3 DocumentReference to FHIR R4 DocumentReference",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T16:03:23.6324796-05:00",
  "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 DocumentReference 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/DocumentReference",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/StructureDefinition/DocumentReference",
      "targetVersion": "4.0.1",
      "element": [
        {
          "code": "DocumentReference.meta",
          "display": "meta",
          "target": [
            {
              "code": "DocumentReference.meta",
              "display": "DocumentReference.meta",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.meta` is mapped to FHIR R4 element `DocumentReference.meta` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.implicitRules",
          "display": "implicitRules",
          "target": [
            {
              "code": "DocumentReference.implicitRules",
              "display": "DocumentReference.implicitRules",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `DocumentReference.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": "DocumentReference.language",
          "display": "language",
          "target": [
            {
              "code": "DocumentReference.language",
              "display": "DocumentReference.language",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.language` is mapped to FHIR R4 element `DocumentReference.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": "DocumentReference.text",
          "display": "text",
          "target": [
            {
              "code": "DocumentReference.text",
              "display": "DocumentReference.text",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.text` is mapped to FHIR R4 element `DocumentReference.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": "DocumentReference.contained",
          "display": "contained",
          "target": [
            {
              "code": "DocumentReference.contained",
              "display": "DocumentReference.contained",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.contained` is mapped to FHIR R4 element `DocumentReference.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": "DocumentReference.masterIdentifier",
          "display": "masterIdentifier",
          "target": [
            {
              "code": "DocumentReference.masterIdentifier",
              "display": "DocumentReference.masterIdentifier",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.masterIdentifier` is mapped to FHIR R4 element `DocumentReference.masterIdentifier` as `Equivalent`.\nCDA Document Id extension and root."
            }
          ]
        },
        {
          "code": "DocumentReference.identifier",
          "display": "identifier",
          "target": [
            {
              "code": "DocumentReference.identifier",
              "display": "DocumentReference.identifier",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.identifier` is mapped to FHIR R4 element `DocumentReference.identifier` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.status",
          "display": "status",
          "target": [
            {
              "code": "DocumentReference.status",
              "display": "DocumentReference.status",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.status` is mapped to FHIR R4 element `DocumentReference.status` as `Equivalent`.\nThis is the status of the DocumentReference object, which might be independent from the docStatus element.\n\nThis element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid."
            }
          ]
        },
        {
          "code": "DocumentReference.docStatus",
          "display": "docStatus",
          "target": [
            {
              "code": "DocumentReference.docStatus",
              "display": "DocumentReference.docStatus",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.docStatus` is mapped to FHIR R4 element `DocumentReference.docStatus` as `Equivalent`.\nThe document that is pointed to might be in various lifecycle states."
            }
          ]
        },
        {
          "code": "DocumentReference.type",
          "display": "type",
          "target": [
            {
              "code": "DocumentReference.type",
              "display": "DocumentReference.type",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.type` is mapped to FHIR R4 element `DocumentReference.type` as `Equivalent`.\nKey metadata element describing the document, used in searching/filtering."
            }
          ]
        },
        {
          "code": "DocumentReference.class",
          "display": "class",
          "target": [
            {
              "code": "DocumentReference.category",
              "display": "DocumentReference.category",
              "equivalence": "narrower",
              "comment": "Element `DocumentReference.class` is mapped to FHIR R4 element `DocumentReference.category` as `SourceIsNarrowerThanTarget`.\nThis is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD))."
            }
          ]
        },
        {
          "code": "DocumentReference.subject",
          "display": "subject",
          "target": [
            {
              "code": "DocumentReference.subject",
              "display": "DocumentReference.subject",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.subject` is mapped to FHIR R4 element `DocumentReference.subject` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.author",
          "display": "author",
          "target": [
            {
              "code": "DocumentReference.author",
              "display": "DocumentReference.author",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.author` is mapped to FHIR R4 element `DocumentReference.author` as `Equivalent`.\nNot necessarily who did the actual data entry (i.e. typist) it in or who was the source (informant)."
            }
          ]
        },
        {
          "code": "DocumentReference.authenticator",
          "display": "authenticator",
          "target": [
            {
              "code": "DocumentReference.authenticator",
              "display": "DocumentReference.authenticator",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.authenticator` is mapped to FHIR R4 element `DocumentReference.authenticator` as `Equivalent`.\nRepresents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator."
            }
          ]
        },
        {
          "code": "DocumentReference.custodian",
          "display": "custodian",
          "target": [
            {
              "code": "DocumentReference.custodian",
              "display": "DocumentReference.custodian",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.custodian` is mapped to FHIR R4 element `DocumentReference.custodian` as `Equivalent`.\nIdentifies the logical organization to go to find the current version, where to report issues, etc. This is different from the physical location of the document, which is the technical location of the document, which host may be delegated to the management of some other organization."
            }
          ]
        },
        {
          "code": "DocumentReference.relatesTo",
          "display": "relatesTo",
          "target": [
            {
              "code": "DocumentReference.relatesTo",
              "display": "DocumentReference.relatesTo",
              "equivalence": "wider",
              "comment": "Element `DocumentReference.relatesTo` is mapped to FHIR R4 element `DocumentReference.relatesTo` as `Equivalent`.\nThis element is labeled as a modifier because documents that append to other documents are incomplete on their own."
            }
          ]
        },
        {
          "code": "DocumentReference.relatesTo.code",
          "display": "code",
          "target": [
            {
              "code": "DocumentReference.relatesTo.code",
              "display": "DocumentReference.relatesTo.code",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.relatesTo.code` is mapped to FHIR R4 element `DocumentReference.relatesTo.code` as `Equivalent`.\nIf this document appends another document, then the document cannot be fully understood without also accessing the referenced document."
            }
          ]
        },
        {
          "code": "DocumentReference.relatesTo.target",
          "display": "target",
          "target": [
            {
              "code": "DocumentReference.relatesTo.target",
              "display": "DocumentReference.relatesTo.target",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.relatesTo.target` is mapped to FHIR R4 element `DocumentReference.relatesTo.target` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.description",
          "display": "description",
          "target": [
            {
              "code": "DocumentReference.description",
              "display": "DocumentReference.description",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.description` is mapped to FHIR R4 element `DocumentReference.description` as `Equivalent`.\nWhat the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a \"consultation\" or \"progress note\")."
            }
          ]
        },
        {
          "code": "DocumentReference.securityLabel",
          "display": "securityLabel",
          "target": [
            {
              "code": "DocumentReference.securityLabel",
              "display": "DocumentReference.securityLabel",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.securityLabel` is mapped to FHIR R4 element `DocumentReference.securityLabel` as `Equivalent`.\nThe confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.   In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects."
            }
          ]
        },
        {
          "code": "DocumentReference.content",
          "display": "content",
          "target": [
            {
              "code": "DocumentReference.content",
              "display": "DocumentReference.content",
              "equivalence": "wider",
              "comment": "Element `DocumentReference.content` is mapped to FHIR R4 element `DocumentReference.content` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.content.attachment",
          "display": "attachment",
          "target": [
            {
              "code": "DocumentReference.content.attachment",
              "display": "DocumentReference.content.attachment",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.content.attachment` is mapped to FHIR R4 element `DocumentReference.content.attachment` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.content.format",
          "display": "format",
          "target": [
            {
              "code": "DocumentReference.content.format",
              "display": "DocumentReference.content.format",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.content.format` is mapped to FHIR R4 element `DocumentReference.content.format` as `Equivalent`.\nNote that while IHE mostly issues URNs for format types, not all documents can be identified by a URI."
            }
          ]
        },
        {
          "code": "DocumentReference.context",
          "display": "context",
          "target": [
            {
              "code": "DocumentReference.context",
              "display": "DocumentReference.context",
              "equivalence": "wider",
              "comment": "Element `DocumentReference.context` is mapped to FHIR R4 element `DocumentReference.context` as `Equivalent`.\nThese values are primarily added to help with searching for interesting/relevant documents."
            }
          ]
        },
        {
          "code": "DocumentReference.context.encounter",
          "display": "encounter",
          "target": [
            {
              "code": "DocumentReference.context.encounter",
              "display": "DocumentReference.context.encounter",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.encounter` is mapped to FHIR R4 element `DocumentReference.context.encounter` as `SourceIsNarrowerThanTarget`."
            }
          ]
        },
        {
          "code": "DocumentReference.context.event",
          "display": "event",
          "target": [
            {
              "code": "DocumentReference.context.event",
              "display": "DocumentReference.context.event",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.event` is mapped to FHIR R4 element `DocumentReference.context.event` as `Equivalent`.\nAn event can further specialize the act inherent in the type, such as  where it is simply \"Procedure Report\" and the procedure was a \"colonoscopy\". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation."
            }
          ]
        },
        {
          "code": "DocumentReference.context.period",
          "display": "period",
          "target": [
            {
              "code": "DocumentReference.context.period",
              "display": "DocumentReference.context.period",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.period` is mapped to FHIR R4 element `DocumentReference.context.period` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.context.facilityType",
          "display": "facilityType",
          "target": [
            {
              "code": "DocumentReference.context.facilityType",
              "display": "DocumentReference.context.facilityType",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.facilityType` is mapped to FHIR R4 element `DocumentReference.context.facilityType` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.context.practiceSetting",
          "display": "practiceSetting",
          "target": [
            {
              "code": "DocumentReference.context.practiceSetting",
              "display": "DocumentReference.context.practiceSetting",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.practiceSetting` is mapped to FHIR R4 element `DocumentReference.context.practiceSetting` as `Equivalent`.\nThe value set for this content has an example binding because it is a value set decided by community policy. Other examples exist for consideration: * HITSP created the table HITSP/C80 Table 2-148 Clinical Specialty Value Set (a value set based upon SNOMED CT which is referenced by Direct (XDR and XDM for Direct Messaging Specification, Version 1), as well as Nationwide Health Information Network (NHIN).  Query for Documents, Web Service Interface Specification, V 3.0, 07/27/2011 * ELGA (Austria) (ELGA CDA Implementie-rungsleitfäden Registrierung von CDA Dokumenten für ELGA mit IHE Cross-Enterprise Document Sharing: XDS Metadaten (XDSDocumentEntry), [1.2.40.0.34.7.6.3] * XDS Connect-a-thon practiceSettingCode."
            }
          ]
        },
        {
          "code": "DocumentReference.context.sourcePatientInfo",
          "display": "sourcePatientInfo",
          "target": [
            {
              "code": "DocumentReference.context.sourcePatientInfo",
              "display": "DocumentReference.context.sourcePatientInfo",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.context.sourcePatientInfo` is mapped to FHIR R4 element `DocumentReference.context.sourcePatientInfo` as `Equivalent`."
            }
          ]
        },
        {
          "code": "DocumentReference.context.related",
          "display": "related",
          "target": [
            {
              "code": "DocumentReference.context.related",
              "display": "DocumentReference.context.related",
              "equivalence": "wider",
              "comment": "Element `DocumentReference.context.related` is mapped to FHIR R4 element `DocumentReference.context.related` as `Equivalent`.\nMay be identifiers or resources that caused the DocumentReference or referenced Document to be created."
            }
          ]
        },
        {
          "code": "DocumentReference.context.related.ref",
          "display": "ref",
          "target": [
            {
              "code": "DocumentReference.context.related",
              "display": "DocumentReference.context.related",
              "equivalence": "narrower",
              "comment": "Element `DocumentReference.context.related.ref` is mapped to FHIR R4 element `DocumentReference.context.related` as `SourceIsNarrowerThanTarget`.\nOrder, ProcedureRequest,  Procedure, EligibilityRequest, etc."
            }
          ]
        }
      ]
    },
    {
      "source": "http://hl7.org/fhir/StructureDefinition/DocumentReference",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/3.0/StructureDefinition/extension-DocumentReference.created",
      "targetVersion": "0.1.0",
      "element": [
        {
          "code": "DocumentReference.created",
          "display": "created",
          "target": [
            {
              "code": "Extension",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.created` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`.\nElement `DocumentReference.created` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nCreation time is used for tracking, organizing versions and searching. This is the creation time of the document, not the source material on which it is based."
            }
          ]
        }
      ]
    },
    {
      "source": "http://hl7.org/fhir/StructureDefinition/DocumentReference",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/3.0/StructureDefinition/extension-DocumentReference.indexed",
      "targetVersion": "0.1.0",
      "element": [
        {
          "code": "DocumentReference.indexed",
          "display": "indexed",
          "target": [
            {
              "code": "Extension",
              "equivalence": "equivalent",
              "comment": "Element `DocumentReference.indexed` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`.\nElement `DocumentReference.indexed` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nReferencing/indexing time is used for tracking, organizing versions and searching."
            }
          ]
        }
      ]
    },
    {
      "source": "http://hl7.org/fhir/StructureDefinition/DocumentReference",
      "sourceVersion": "3.0.2",
      "target": "http://hl7.org/fhir/3.0/StructureDefinition/extension-DocumentReference.context.related.identifier",
      "targetVersion": "0.1.0",
      "element": [
        {
          "code": "DocumentReference.context.related.identifier",
          "display": "identifier",
          "target": [
            {
              "code": "Extension",
              "equivalence": "wider",
              "comment": "Element `DocumentReference.context.related.identifier` has a context of DocumentReference.context.related based on following the parent source element upwards and mapping to `DocumentReference`.\nElement `DocumentReference.context.related.identifier` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).\nOrder numbers, accession numbers, XDW workflow numbers."
            }
          ]
        }
      ]
    }
  ]
}