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Source1

{
  "resourceType": "StructureDefinition",
  "id": "ie-core-composition-patient-summary",
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile",
      "valueCanonical": "http://hl7.org/fhir/uv/ips/StructureDefinition/Composition-uv-ips"
    }
  ],
  "url": "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-composition-patient-summary",
  "version": "0.2.0",
  "name": "IECoreCompositionPatientSummary",
  "title": "IE Core Composition (Patient Summary)",
  "status": "draft",
  "description": "The Irish Patient Summary document (HIQA PS Groups 1–3, Sections 1–19), derived from the HL7 Europe Patient Summary Composition, which imposes the IPS Composition. Section slices and section codes are inherited from EPS. IE Core adds the HIQA constraints: the subject is IECorePatientSummaryPatient; every section HIQA gives an empty reason to must carry entries or an emptyReason; document provenance per HIQA PS 19.1.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Composition",
  "baseDefinition": "http://hl7.eu/fhir/eps/StructureDefinition/composition-eu-eps",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Composition",
        "path": "Composition",
        "constraint": [
          {
            "key": "ie-ps-attester-1",
            "severity": "error",
            "human": "Each attestation or legal authentication SHALL identify who attested and when (HIQA PS 19.1.11.1/.2, 19.1.12.1/.2)",
            "expression": "attester.all(party.exists() and time.exists())",
            "source": "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-composition-patient-summary"
          },
          {
            "key": "ie-ps-1",
            "severity": "error",
            "human": "Each Patient Summary section for which HIQA defines an empty reason (alerts, allergies, medication, health conditions, procedures, devices, advance healthcare directive, immunisation) SHALL contain entries or an emptyReason (HIQA PS 4.2, 5.2, 6.2, 7.2, 9.2, 10.2, 13.2, 16.2)",
            "expression": "section.where(code.coding.where(system = 'http://loinc.org' and (code = '104605-1' or code = '48765-2' or code = '10160-0' or code = '11450-4' or code = '47519-4' or code = '46264-8' or code = '42348-3' or code = '11369-6')).exists()).all(entry.exists() or emptyReason.exists())",
            "source": "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-composition-patient-summary"
          }
        ]
      },
      {
        "id": "Composition.language",
        "path": "Composition.language",
        "comment": "HIQA PS 19.1.6 Document language (Optional)."
      },
      {
        "id": "Composition.identifier",
        "path": "Composition.identifier",
        "comment": "HIQA PS 19.1.2 Document identifier (Mandatory 1..*). R4 Composition.identifier is 0..1; the Bundle identifier (IECoreBundlePatientSummary, 1..1) carries the stable document identifier.",
        "mustSupport": true
      },
      {
        "id": "Composition.status",
        "path": "Composition.status",
        "comment": "HIQA PS 19.1.5 Document status (Mandatory 1..1): e.g. preliminary, final, amended.",
        "mustSupport": true
      },
      {
        "id": "Composition.type",
        "path": "Composition.type",
        "comment": "HIQA PS 19.1.7 Document type (Mandatory 1..1): LOINC 60591-5 Patient summary (inherited).",
        "mustSupport": true
      },
      {
        "id": "Composition.subject",
        "path": "Composition.subject",
        "comment": "HIQA PS 19.1.1 Document subject (Mandatory 1..1); PS Section 1 Patient Details.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-patient-summary-patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.date",
        "path": "Composition.date",
        "comment": "HIQA PS 19.1.4 Document date (Mandatory 1..1).",
        "mustSupport": true
      },
      {
        "id": "Composition.author",
        "path": "Composition.author",
        "comment": "HIQA PS 19.1.3 Document author (Mandatory 1..*): person, organisation or device.",
        "mustSupport": true
      },
      {
        "id": "Composition.title",
        "path": "Composition.title",
        "comment": "HIQA PS 19.1.8 Document title (Mandatory 1..1). HIQA: a high-level title, without detailed clinical information.",
        "mustSupport": true
      },
      {
        "id": "Composition.attester",
        "path": "Composition.attester",
        "comment": "HIQA PS 19.1.11 Attestation (Optional; mode = professional) and 19.1.12 Legal authentication (Optional; mode = legal).",
        "mustSupport": true
      },
      {
        "id": "Composition.attester.time",
        "path": "Composition.attester.time",
        "comment": "HIQA PS 19.1.11.2 / 19.1.12.2 date and time: Mandatory within each cluster (invariant ie-ps-attester-1).",
        "mustSupport": true
      },
      {
        "id": "Composition.attester.party",
        "path": "Composition.attester.party",
        "comment": "HIQA PS 19.1.11.1 Attester / 19.1.12.1 Legal authenticator: Mandatory within each cluster (invariant ie-ps-attester-1).",
        "mustSupport": true
      },
      {
        "id": "Composition.attester:legalAuthenticator",
        "path": "Composition.attester",
        "sliceName": "legalAuthenticator"
      },
      {
        "id": "Composition.attester:legalAuthenticator.time",
        "path": "Composition.attester.time",
        "mustSupport": true
      },
      {
        "id": "Composition.attester:legalAuthenticator.party",
        "path": "Composition.attester.party",
        "mustSupport": true
      },
      {
        "id": "Composition.attester:validator",
        "path": "Composition.attester",
        "sliceName": "validator"
      },
      {
        "id": "Composition.attester:validator.time",
        "path": "Composition.attester.time",
        "mustSupport": true
      },
      {
        "id": "Composition.attester:validator.party",
        "path": "Composition.attester.party",
        "mustSupport": true
      },
      {
        "id": "Composition.custodian",
        "path": "Composition.custodian",
        "comment": "HIQA PS 19.1.15 Custodian (Optional).",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-organization"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.event.code",
        "path": "Composition.event.code",
        "comment": "HIQA PS 19.1.13 Event type (Optional)."
      },
      {
        "id": "Composition.event.period",
        "path": "Composition.event.period",
        "comment": "HIQA PS 19.1.9 Document period (Optional)."
      },
      {
        "id": "Composition.section:sectionProblems",
        "path": "Composition.section",
        "sliceName": "sectionProblems",
        "comment": "HIQA PS Section 7 Health Conditions: 7.2 empty reason (Required), 7.3 health condition (Required 0..*). Entries SHOULD also conform to IECoreConditionProblemsHealthConcerns.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProblems.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProblems.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProblems.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAllergies",
        "path": "Composition.section",
        "sliceName": "sectionAllergies",
        "comment": "HIQA PS Section 5 Allergies and Intolerances: 5.2 empty reason (Required), 5.3 record entry (Required 0..*). Entries SHOULD also conform to IECoreAllergyIntolerance.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAllergies.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAllergies.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAllergies.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedications",
        "path": "Composition.section",
        "sliceName": "sectionMedications",
        "comment": "HIQA PS Section 6 Medication Information: 6.2 empty reason (Required), 6.3 medication (Required). Entries SHOULD also conform to IECoreMedicationStatement.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedications.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedications.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedications.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionImmunizations",
        "path": "Composition.section",
        "sliceName": "sectionImmunizations",
        "comment": "HIQA PS Section 16 Immunisation Information: 16.2 empty reason (Required), 16.3 immunisations (Required 0..*). Entries SHOULD also conform to IECoreImmunization.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionImmunizations.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionImmunizations.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionImmunizations.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionResults",
        "path": "Composition.section",
        "sliceName": "sectionResults",
        "comment": "HIQA PS Section 8 Observation Results (8.2 Required 0..*): EU Base medical test results / HL7 Europe Laboratory where applicable.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionResults.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionResults.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProceduresHx",
        "path": "Composition.section",
        "sliceName": "sectionProceduresHx",
        "comment": "HIQA PS Section 9 Procedures, Operations and Treatments: 9.2 empty reason (Required), 9.3 record entry (Required 0..*). Entries SHOULD also conform to IECoreProcedure.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProceduresHx.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProceduresHx.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionProceduresHx.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedicalDevices",
        "path": "Composition.section",
        "sliceName": "sectionMedicalDevices",
        "comment": "HIQA PS Section 10 Medical Devices/Implants: 10.2 empty reason (Required), 10.3 record entry (Required 0..*) as DeviceUseStatement (period of use, status, body site, reason) referencing the device (IECoreImplantableDevice).",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedicalDevices.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedicalDevices.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionMedicalDevices.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAdvanceDirectives",
        "path": "Composition.section",
        "sliceName": "sectionAdvanceDirectives",
        "comment": "HIQA PS Section 13 Advance Healthcare Directive: 13.2 empty reason (Required), 13.3 AHD (Required 0..*). IE Core uses IECoreADIDocumentReference (ADR-004): under the Assisted Decision-Making (Capacity) Act 2015 an AHD is a written document, and the attachment (13.3.2) is authoritative.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAdvanceDirectives.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAdvanceDirectives.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAdvanceDirectives.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAlert",
        "path": "Composition.section",
        "sliceName": "sectionAlert",
        "comment": "HIQA PS Section 4 Alerts: 4.1 narrative, 4.2 empty reason (Required), 4.3 alerts (Required 0..*; Flag). Entries SHOULD also conform to IECoreFlag.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAlert.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAlert.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionAlert.emptyReason",
        "path": "Composition.section.emptyReason",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionFunctionalStatus",
        "path": "Composition.section",
        "sliceName": "sectionFunctionalStatus",
        "comment": "HIQA PS Section 17 Functional Status (17.2–17.4 Required).",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionFunctionalStatus.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionFunctionalStatus.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPregnancyHx",
        "path": "Composition.section",
        "sliceName": "sectionPregnancyHx",
        "comment": "HIQA PS Section 15 Pregnancy Information: current pregnancy (15.2: status, EDD, gestational age) and pregnancy history (15.3: outcome).",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPregnancyHx.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPregnancyHx.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPatientStory",
        "path": "Composition.section",
        "sliceName": "sectionPatientStory",
        "comment": "HIQA PS Section 11 Patient Provided Data: 11.1 patient story (Optional; narrative).",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPatientStory.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPlanOfCare",
        "path": "Composition.section",
        "sliceName": "sectionPlanOfCare",
        "comment": "HIQA PS Section 18 Care Plan (18.2 Required 0..1). Entries SHOULD also conform to IECoreCarePlan.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPlanOfCare.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionPlanOfCare.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionSocialHistory",
        "path": "Composition.section",
        "sliceName": "sectionSocialHistory",
        "comment": "HIQA PS Section 12 Social Context: living situation (12.2), what matters to the patient (12.3), family situation (12.4) and other determinants of health (12.5) are free text in HIQA (Required) and are carried in the section narrative.",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionSocialHistory.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionTravelHx",
        "path": "Composition.section",
        "sliceName": "sectionTravelHx",
        "comment": "HIQA PS Section 14 Travel History (14.2 Required 0..*): EPS travel observation (country visited, period, infectious agent).",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionTravelHx.text",
        "path": "Composition.section.text",
        "mustSupport": true
      },
      {
        "id": "Composition.section:sectionTravelHx.entry",
        "path": "Composition.section.entry",
        "mustSupport": true
      }
    ]
  }
}