HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1

HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1 - Local Development build (v0.9.1). See the Directory of published versions

PrimaryCancerCondition

{
  "resourceType" : "StructureDefinition",
  "id" : "onco-core-PrimaryCancerCondition",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>PrimaryCancerCondition Profile</b></p>\n  <p>Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.\n\nCancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.\n\nConformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.</p>\n  <p><b>Mapping Summary</b></p>\n  <p><pre>onco.core.PrimaryCancerCondition maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:\n  Language maps to language\n  ImplicitRules maps to implicitRules\n  Metadata.VersionId maps to meta.versionId\n  Metadata.SourceSystem maps to meta.source\n  Metadata.Profile maps to meta.profile\n  Metadata.LastUpdated maps to meta.lastUpdated\n  Metadata.SecurityLabel maps to meta.security\n  Metadata.Tag maps to meta.tag\n  Narrative maps to text\n  Identifier maps to identifier\n  ClinicalStatus maps to clinicalStatus\n  Status maps to verificationStatus\n  Category maps to category\n  Severity maps to severity\n  Code maps to code\n  BodyLocation.Code maps to bodySite\n  BodyLocation.Laterality maps to bodySite.extension\n  BodyLocation.AnatomicalOrientation maps to bodySite.extension\n  BodyLocation.RelationToLandmark maps to bodySite.extension\n  SubjectOfRecord maps to subject\n  CareContext maps to encounter\n  Onset maps to onset[x]\n  Abatement maps to abatement[x]\n  StatementDateTime maps to recordedDate\n  Author maps to recorder\n  PractitionerInformationSource maps to asserter\n  StageInformation maps to stage\n  StageInformation.StageSummary maps to stage.summary\n  StageInformation.StageDetail maps to stage.assessment\n  StageInformation.Type maps to stage.type\n  Evidence.Manifestation maps to evidence.code\n  Evidence.Resource maps to evidence.detail\n  Annotation maps to note\n  DateOfDiagnosis maps to http://hl7.org/fhir/StructureDefinition/condition-assertedDate\n</pre></p>\n</div>"
  },
  "url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-PrimaryCancerCondition",
  "version" : "0.9.1",
  "name" : "PrimaryCancerCondition",
  "title" : "onco-core-PrimaryCancerCondition",
  "status" : "active",
  "experimental" : false,
  "date" : "2019-08-01T00:00:00-04:00",
  "publisher" : "HL7 International Clinical Interoperability Council",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cic"
        }
      ]
    }
  ],
  "description" : "Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.\n\nCancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.\n\nConformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "fhirVersion" : "4.0.0",
  "mapping" : [
    {
      "identity" : "argonaut-dq-dstu2",
      "uri" : "http://unknown.org/Argonaut-DQ-DSTU2",
      "name" : "Argonaut-DQ-DSTU2"
    },
    {
      "identity" : "workflow",
      "uri" : "http://hl7.org/fhir/workflow",
      "name" : "Workflow Pattern"
    },
    {
      "identity" : "sct-concept",
      "uri" : "http://snomed.info/conceptdomain",
      "name" : "SNOMED CT Concept Domain Binding"
    },
    {
      "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"
    },
    {
      "identity" : "sct-attr",
      "uri" : "http://snomed.org/attributebinding",
      "name" : "SNOMED CT Attribute Binding"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Condition",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "Condition",
        "path" : "Condition",
        "short" : "onco-core-PrimaryCancerCondition",
        "definition" : "Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.\n\nCancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.\n\nConformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition",
          "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" : "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" : "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 $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
            "source" : "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" : "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" : "DomainResource"
          },
          {
            "key" : "con-5",
            "severity" : "error",
            "human" : "Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error",
            "expression" : "verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()",
            "xpath" : "not(exists(f:verificationStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-ver-status' and f:code/@value='entered-in-error'])) or not(exists(f:clinicalStatus))",
            "source" : "Condition"
          },
          {
            "key" : "con-4",
            "severity" : "error",
            "human" : "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
            "expression" : "abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()",
            "xpath" : "not(exists(*[starts-with(local-name(.), 'abatement')])) or exists(f:clinicalStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-clinical' and f:code/@value=('resolved', 'remission', 'inactive')])",
            "source" : "Condition"
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                "valueBoolean" : true
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                "valueMarkdown" : "Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis."
              }
            ],
            "key" : "con-3",
            "severity" : "warning",
            "human" : "Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item",
            "expression" : "clinicalStatus.exists() or verificationStatus='entered-in-error' or category.select($this='problem-list-item').empty()",
            "xpath" : "exists(f:clinicalStatus) or f:verificationStatus/@value='entered-in-error' or not(exists(category[@value='problem-list-item']))",
            "source" : "Condition"
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                "valueBoolean" : true
              }
            ],
            "key" : "us-core-1",
            "severity" : "warning",
            "human" : "A code in Condition.category SHOULD be from US Core Condition Category Codes value set.",
            "expression" : "where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()",
            "xpath" : "(no xpath equivalent)"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Entity. Role, or Act"
          },
          {
            "identity" : "workflow",
            "map" : "Event"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)"
          },
          {
            "identity" : "v2",
            "map" : "PPR message"
          },
          {
            "identity" : "rim",
            "map" : "Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition"
          }
        ]
      },
      {
        "id" : "Condition.id",
        "path" : "Condition.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" : [
          {
            "code" : "id"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "Condition.meta",
        "path" : "Condition.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "Condition.implicitRules",
        "path" : "Condition.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"
          }
        ],
        "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" : "Condition.language",
        "path" : "Condition.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"
          }
        ],
        "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"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "preferred",
          "description" : "A human language.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      {
        "id" : "Condition.text",
        "path" : "Condition.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Act.text?"
          }
        ]
      },
      {
        "id" : "Condition.contained",
        "path" : "Condition.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" : "Condition.extension",
        "path" : "Condition.extension",
        "slicing" : {
          "id" : "2",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "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 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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Condition.extension:dateofdiagnosis",
        "path" : "Condition.extension",
        "sliceName" : "dateofdiagnosis",
        "definition" : "The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/StructureDefinition/condition-assertedDate"
            ]
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.extension:histologymorphologybehavior",
        "path" : "Condition.extension",
        "sliceName" : "histologymorphologybehavior",
        "definition" : "A description of the morphologic and behavioral characteristics of the cancer.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-HistologyMorphologyBehavior-extension"
            ]
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.modifierExtension",
        "path" : "Condition.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"
          }
        ],
        "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" : "Condition.identifier",
        "path" : "Condition.identifier",
        "short" : "External Ids for this condition",
        "definition" : "Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
        "comment" : "This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.",
        "requirements" : "Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.identifier",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.identifier"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.identifier"
          },
          {
            "identity" : "rim",
            "map" : ".id"
          }
        ]
      },
      {
        "id" : "Condition.clinicalStatus",
        "path" : "Condition.clinicalStatus",
        "short" : "active | recurrence | relapse | inactive | remission | resolved",
        "definition" : "The clinical status of the condition.",
        "comment" : "The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.clinicalStatus",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "condition" : [
          "con-3",
          "con-4",
          "con-5"
        ],
        "mustSupport" : true,
        "isModifier" : true,
        "isModifierReason" : "This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.",
        "isSummary" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/ValueSet/condition-clinical"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.status"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.status"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 303105007 |Disease phases|"
          },
          {
            "identity" : "v2",
            "map" : "PRB-14"
          },
          {
            "identity" : "rim",
            "map" : "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition.clinicalStatus"
          }
        ]
      },
      {
        "id" : "Condition.verificationStatus",
        "path" : "Condition.verificationStatus",
        "short" : "unconfirmed | provisional | differential | confirmed | refuted | entered-in-error",
        "definition" : "The verification status to support the clinical status of the condition.",
        "comment" : "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\nThe data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Condition.verificationStatus",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "condition" : [
          "con-3",
          "con-5"
        ],
        "mustSupport" : true,
        "isModifier" : true,
        "isModifierReason" : "This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
        "isSummary" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/ValueSet/condition-ver-status"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.status"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.status"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 410514004 |Finding context value|"
          },
          {
            "identity" : "v2",
            "map" : "PRB-13"
          },
          {
            "identity" : "rim",
            "map" : "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
          },
          {
            "identity" : "sct-attr",
            "map" : "408729009"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition.verificationStatus"
          }
        ]
      },
      {
        "id" : "Condition.category",
        "path" : "Condition.category",
        "short" : "problem-list-item | encounter-diagnosis",
        "definition" : "A category assigned to the condition.",
        "comment" : "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Condition.category",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "strength" : "extensible",
          "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"
        },
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.class"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 404684003 |Clinical finding|"
          },
          {
            "identity" : "v2",
            "map" : "'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition.category"
          }
        ]
      },
      {
        "id" : "Condition.category.id",
        "path" : "Condition.category.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" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.category.extension",
        "path" : "Condition.category.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.category.coding",
        "path" : "Condition.category.coding",
        "slicing" : {
          "id" : "1",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "code"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "short" : "Code defined by a terminology system",
        "definition" : "A reference to a code defined by a terminology system.",
        "comment" : "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
        "requirements" : "Allows for alternative encodings within a code system, and translations to other code systems.",
        "min" : 1,
        "max" : "*",
        "base" : {
          "path" : "CodeableConcept.coding",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.1-8, C*E.10-22"
          },
          {
            "identity" : "rim",
            "map" : "union(., ./translation)"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001",
        "path" : "Condition.category.coding",
        "sliceName" : "Fixed_64572001",
        "short" : "Disease",
        "definition" : "Disease",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "CodeableConcept.coding",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.id",
        "path" : "Condition.category.coding.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" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.extension",
        "path" : "Condition.category.coding.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.system",
        "path" : "Condition.category.coding.system",
        "short" : "Identity of the terminology system",
        "definition" : "The identification of the code system that defines the meaning of the symbol in the code.",
        "comment" : "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
        "requirements" : "Need to be unambiguous about the source of the definition of the symbol.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Coding.system",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "fixedUri" : "http://snomed.info/sct",
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.3"
          },
          {
            "identity" : "rim",
            "map" : "./codeSystem"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.version",
        "path" : "Condition.category.coding.version",
        "short" : "Version of the system - if relevant",
        "definition" : "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
        "comment" : "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Coding.version",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.7"
          },
          {
            "identity" : "rim",
            "map" : "./codeSystemVersion"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.code",
        "path" : "Condition.category.coding.code",
        "short" : "Symbol in syntax defined by the system",
        "definition" : "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
        "requirements" : "Need to refer to a particular code in the system.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Coding.code",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "fixedCode" : "64572001",
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.1"
          },
          {
            "identity" : "rim",
            "map" : "./code"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.display",
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean" : true
          }
        ],
        "path" : "Condition.category.coding.display",
        "short" : "Representation defined by the system",
        "definition" : "A representation of the meaning of the code in the system, following the rules of the system.",
        "requirements" : "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Coding.display",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.2 - but note this is not well followed"
          },
          {
            "identity" : "rim",
            "map" : "CV.displayName"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
          }
        ]
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.userSelected",
        "path" : "Condition.category.coding.userSelected",
        "short" : "If this coding was chosen directly by the user",
        "definition" : "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
        "comment" : "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
        "requirements" : "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Coding.userSelected",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "boolean"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "Sometimes implied by being first"
          },
          {
            "identity" : "rim",
            "map" : "CD.codingRationale"
          },
          {
            "identity" : "orim",
            "map" : "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
          }
        ]
      },
      {
        "id" : "Condition.category.text",
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean" : true
          }
        ],
        "path" : "Condition.category.text",
        "short" : "Plain text representation of the concept",
        "definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
        "comment" : "Very often the text is the same as a displayName of one of the codings.",
        "requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "CodeableConcept.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.9. But note many systems use C*E.2 for this"
          },
          {
            "identity" : "rim",
            "map" : "./originalText[mediaType/code=\"text/plain\"]/data"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
          }
        ]
      },
      {
        "id" : "Condition.severity",
        "path" : "Condition.severity",
        "short" : "Subjective severity of condition",
        "definition" : "A subjective assessment of the severity of the condition as evaluated by the clinician.",
        "comment" : "Coding of the severity with a terminology is preferred, where possible.",
        "min" : 0,
        "max" : "0",
        "base" : {
          "path" : "Condition.severity",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ConditionSeverity"
            }
          ],
          "strength" : "preferred",
          "description" : "A subjective assessment of the severity of the condition as evaluated by the clinician.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/condition-severity"
        },
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.grade"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 272141005 |Severities|"
          },
          {
            "identity" : "v2",
            "map" : "PRB-26 / ABS-3"
          },
          {
            "identity" : "rim",
            "map" : "Can be pre/post-coordinated into value.  Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"severity\"].value"
          },
          {
            "identity" : "sct-attr",
            "map" : "246112005"
          }
        ]
      },
      {
        "id" : "Condition.code",
        "path" : "Condition.code",
        "short" : "Identification of the condition, problem or diagnosis",
        "definition" : "Identification of the condition, problem or diagnosis.",
        "requirements" : "0..1 to account for primarily narrative only resources.",
        "alias" : [
          "type"
        ],
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Condition.code",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "strength" : "extensible",
          "valueSet" : "http://hl7.org/fhir/us/mcode/ValueSet/onco-core-PrimaryOrUncertainBehaviorCancerDisorderVS"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.code"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.what[x]"
          },
          {
            "identity" : "sct-concept",
            "map" : "code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS\n<< 420134006 |Propensity to adverse reactions| MINUS \n<< 473010000 |Hypersensitivity condition| MINUS \n<< 79899007 |Drug interaction| MINUS\n<< 69449002 |Drug action| MINUS \n<< 441742003 |Evaluation finding| MINUS \n<< 307824009 |Administrative status| MINUS \n<< 385356007 |Tumor stage finding|) \nOR < 413350009 |Finding with explicit context|\nOR < 272379006 |Event|"
          },
          {
            "identity" : "v2",
            "map" : "PRB-3"
          },
          {
            "identity" : "rim",
            "map" : ".value"
          },
          {
            "identity" : "sct-attr",
            "map" : "246090004"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition.code"
          }
        ]
      },
      {
        "id" : "Condition.bodySite",
        "path" : "Condition.bodySite",
        "short" : "Anatomical location, if relevant",
        "definition" : "The anatomical location where this condition manifests itself.",
        "comment" : "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.bodySite",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "strength" : "preferred",
          "valueSet" : "http://hl7.org/fhir/us/mcode/ValueSet/onco-core-CancerBodyLocationVS"
        },
        "mapping" : [
          {
            "identity" : "sct-concept",
            "map" : "< 442083009  |Anatomical or acquired body structure|"
          },
          {
            "identity" : "rim",
            "map" : ".targetBodySiteCode"
          },
          {
            "identity" : "sct-attr",
            "map" : "363698007"
          }
        ]
      },
      {
        "id" : "Condition.bodySite.id",
        "path" : "Condition.bodySite.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" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.bodySite.extension",
        "path" : "Condition.bodySite.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.bodySite.extension:laterality",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "laterality",
        "definition" : "Body side of the body location, if needed to distinguish from a similar location on the other side of the body.\n\nThe laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.bodySite.extension:anatomicalorientation",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "anatomicalorientation",
        "definition" : "AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation.\nThe orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.bodySite.extension:relationtolandmark",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "relationtolandmark",
        "definition" : "The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by:\n* Specifying the location and type of landmark using a body site code and optional laterality/orientation,\n* Specifying the direction from the landmark to the body location, and\n* Specifying the distance from the landmark to the body location.\n\nThe RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.bodySite.coding",
        "path" : "Condition.bodySite.coding",
        "short" : "Code defined by a terminology system",
        "definition" : "A reference to a code defined by a terminology system.",
        "comment" : "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
        "requirements" : "Allows for alternative encodings within a code system, and translations to other code systems.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "CodeableConcept.coding",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.1-8, C*E.10-22"
          },
          {
            "identity" : "rim",
            "map" : "union(., ./translation)"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
          }
        ]
      },
      {
        "id" : "Condition.bodySite.text",
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean" : true
          }
        ],
        "path" : "Condition.bodySite.text",
        "short" : "Plain text representation of the concept",
        "definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
        "comment" : "Very often the text is the same as a displayName of one of the codings.",
        "requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "CodeableConcept.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "C*E.9. But note many systems use C*E.2 for this"
          },
          {
            "identity" : "rim",
            "map" : "./originalText[mediaType/code=\"text/plain\"]/data"
          },
          {
            "identity" : "orim",
            "map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
          }
        ]
      },
      {
        "id" : "Condition.subject",
        "path" : "Condition.subject",
        "short" : "Who has the condition?",
        "definition" : "Indicates the patient or group who the condition record is associated with.",
        "requirements" : "Group is typically used for veterinary or public health use cases.",
        "alias" : [
          "patient"
        ],
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Condition.subject",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"
            ]
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.subject"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.subject[x]"
          },
          {
            "identity" : "v2",
            "map" : "PID-3"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].role[classCode=PAT]"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.subject"
          },
          {
            "identity" : "argonaut-dq-dstu2",
            "map" : "Condition.patient"
          }
        ]
      },
      {
        "id" : "Condition.encounter",
        "path" : "Condition.encounter",
        "short" : "Encounter created as part of",
        "definition" : "The Encounter during which this Condition was created or to which the creation of this record is tightly associated.",
        "comment" : "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.encounter",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.context"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.context"
          },
          {
            "identity" : "v2",
            "map" : "PV1-19 (+PV1-54)"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Condition.onset[x]",
        "path" : "Condition.onset[x]",
        "short" : "Estimated or actual date,  date-time, or age",
        "definition" : "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
        "comment" : "Age is generally used when the patient reports an age at which the Condition began to occur.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.onset[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          },
          {
            "code" : "Age"
          },
          {
            "code" : "Period"
          },
          {
            "code" : "Range"
          },
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.occurrence[x]"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.init"
          },
          {
            "identity" : "v2",
            "map" : "PRB-16"
          },
          {
            "identity" : "rim",
            "map" : ".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age at onset\"].value"
          }
        ]
      },
      {
        "id" : "Condition.abatement[x]",
        "path" : "Condition.abatement[x]",
        "short" : "When in resolution/remission",
        "definition" : "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
        "comment" : "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.abatement[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          },
          {
            "code" : "Age"
          },
          {
            "code" : "Period"
          },
          {
            "code" : "Range"
          },
          {
            "code" : "string"
          }
        ],
        "condition" : [
          "con-4"
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.done[x]"
          },
          {
            "identity" : "rim",
            "map" : ".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age at remission\"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed"
          }
        ]
      },
      {
        "id" : "Condition.recordedDate",
        "path" : "Condition.recordedDate",
        "short" : "Date record was first recorded",
        "definition" : "The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.recordedDate",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.recorded"
          },
          {
            "identity" : "v2",
            "map" : "REL-11"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=AUT].time"
          }
        ]
      },
      {
        "id" : "Condition.recorder",
        "path" : "Condition.recorder",
        "short" : "Who recorded the condition",
        "definition" : "Individual who recorded the record and takes responsibility for its content.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.recorder",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole",
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.author"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=AUT].role"
          }
        ]
      },
      {
        "id" : "Condition.asserter",
        "path" : "Condition.asserter",
        "short" : "The information comes from a practitioner who asserts the condition",
        "definition" : "The information comes from a practitioner who asserts the condition.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.asserter",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.source"
          },
          {
            "identity" : "v2",
            "map" : "REL-7.1 identifier + REL-7.12 type code"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=INF].role"
          }
        ]
      },
      {
        "id" : "Condition.stage",
        "path" : "Condition.stage",
        "short" : "Stage/grade, usually assessed formally",
        "definition" : "Clinical stage or grade of a condition. May include formal severity assessments.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.stage",
          "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" : "Element"
          },
          {
            "key" : "con-1",
            "severity" : "error",
            "human" : "Stage SHALL have summary or assessment",
            "expression" : "summary.exists() or assessment.exists()",
            "xpath" : "exists(f:summary) or exists(f:assessment)"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"stage/grade\"]"
          }
        ]
      },
      {
        "id" : "Condition.stage.id",
        "path" : "Condition.stage.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" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.stage.extension",
        "path" : "Condition.stage.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.stage.modifierExtension",
        "path" : "Condition.stage.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"
          }
        ],
        "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" : "Condition.stage.summary",
        "path" : "Condition.stage.summary",
        "short" : "Simple summary (disease specific)",
        "definition" : "A simple summary of the stage such as \"Stage 3\". The determination of the stage is disease-specific.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.stage.summary",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "condition" : [
          "con-1"
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ConditionStage"
            }
          ],
          "strength" : "example",
          "description" : "Codes describing condition stages (e.g. Cancer stages).",
          "valueSet" : "http://hl7.org/fhir/ValueSet/condition-stage"
        },
        "mapping" : [
          {
            "identity" : "sct-concept",
            "map" : "< 254291000 |Staging and scales|"
          },
          {
            "identity" : "v2",
            "map" : "PRB-14"
          },
          {
            "identity" : "rim",
            "map" : ".value"
          }
        ]
      },
      {
        "id" : "Condition.stage.assessment",
        "path" : "Condition.stage.assessment",
        "short" : "Formal record of assessment",
        "definition" : "Reference to a formal record of the evidence on which the staging assessment is based.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.stage.assessment",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-CancerStageGroup"
            ]
          }
        ],
        "condition" : [
          "con-1"
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".self"
          }
        ]
      },
      {
        "id" : "Condition.stage.type",
        "path" : "Condition.stage.type",
        "short" : "Kind of staging",
        "definition" : "The kind of staging, such as pathological or clinical staging.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Condition.stage.type",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ConditionStageType"
            }
          ],
          "strength" : "example",
          "description" : "Codes describing the kind of condition staging (e.g. clinical or pathological).",
          "valueSet" : "http://hl7.org/fhir/ValueSet/condition-stage-type"
        },
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"stage type\"]"
          }
        ]
      },
      {
        "id" : "Condition.evidence",
        "path" : "Condition.evidence",
        "short" : "Supporting evidence",
        "definition" : "Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.",
        "comment" : "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.evidence",
          "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" : "Element"
          },
          {
            "key" : "con-2",
            "severity" : "error",
            "human" : "evidence SHALL have code or details",
            "expression" : "code.exists() or detail.exists()",
            "xpath" : "exists(f:code) or exists(f:detail)"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Condition.evidence.id",
        "path" : "Condition.evidence.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" : [
          {
            "code" : "string"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.evidence.extension",
        "path" : "Condition.evidence.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"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Condition.evidence.modifierExtension",
        "path" : "Condition.evidence.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"
          }
        ],
        "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" : "Condition.evidence.code",
        "path" : "Condition.evidence.code",
        "short" : "Manifestation/symptom",
        "definition" : "A manifestation or symptom that led to the recording of this condition.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.evidence.code",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "condition" : [
          "con-2"
        ],
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "strength" : "example",
          "valueSet" : "http://hl7.org/fhir/ValueSet/clinical-findings"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.reasonCode"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.why[x]"
          },
          {
            "identity" : "sct-concept",
            "map" : "< 404684003 |Clinical finding|"
          },
          {
            "identity" : "rim",
            "map" : "[code=\"diagnosis\"].value"
          }
        ]
      },
      {
        "id" : "Condition.evidence.detail",
        "path" : "Condition.evidence.detail",
        "short" : "Supporting information found elsewhere",
        "definition" : "Links to other relevant information, including pathology reports.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.evidence.detail",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ],
        "condition" : [
          "con-2"
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "w5",
            "map" : "FiveWs.why[x]"
          },
          {
            "identity" : "rim",
            "map" : ".self"
          }
        ]
      },
      {
        "id" : "Condition.note",
        "path" : "Condition.note",
        "short" : "Additional information about the Condition",
        "definition" : "Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Condition.note",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Annotation"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Event.note"
          },
          {
            "identity" : "v2",
            "map" : "NTE child of PRB"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "Condition",
        "path" : "Condition",
        "short" : "onco-core-PrimaryCancerCondition",
        "definition" : "Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.\n\nCancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.\n\nConformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.",
        "mustSupport" : false,
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.extension",
        "path" : "Condition.extension",
        "slicing" : {
          "id" : "2",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "Condition.extension:dateofdiagnosis",
        "path" : "Condition.extension",
        "sliceName" : "dateofdiagnosis",
        "definition" : "The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/StructureDefinition/condition-assertedDate"
            ]
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.extension:histologymorphologybehavior",
        "path" : "Condition.extension",
        "sliceName" : "histologymorphologybehavior",
        "definition" : "A description of the morphologic and behavioral characteristics of the cancer.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-HistologyMorphologyBehavior-extension"
            ]
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.verificationStatus",
        "path" : "Condition.verificationStatus",
        "min" : 1,
        "max" : "1"
      },
      {
        "id" : "Condition.category",
        "path" : "Condition.category",
        "min" : 1,
        "max" : "1"
      },
      {
        "id" : "Condition.category.coding",
        "path" : "Condition.category.coding",
        "slicing" : {
          "id" : "1",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "code"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "min" : 1,
        "max" : "*"
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001",
        "path" : "Condition.category.coding",
        "sliceName" : "Fixed_64572001",
        "short" : "Disease",
        "definition" : "Disease",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "CodeableConcept.coding",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.system",
        "path" : "Condition.category.coding.system",
        "fixedUri" : "http://snomed.info/sct"
      },
      {
        "id" : "Condition.category.coding:Fixed_64572001.code",
        "path" : "Condition.category.coding.code",
        "fixedCode" : "64572001"
      },
      {
        "id" : "Condition.severity",
        "path" : "Condition.severity",
        "min" : 0,
        "max" : "0"
      },
      {
        "id" : "Condition.code",
        "path" : "Condition.code",
        "binding" : {
          "strength" : "extensible",
          "valueSet" : "http://hl7.org/fhir/us/mcode/ValueSet/onco-core-PrimaryOrUncertainBehaviorCancerDisorderVS"
        }
      },
      {
        "id" : "Condition.bodySite",
        "path" : "Condition.bodySite",
        "mustSupport" : true,
        "binding" : {
          "strength" : "preferred",
          "valueSet" : "http://hl7.org/fhir/us/mcode/ValueSet/onco-core-CancerBodyLocationVS"
        }
      },
      {
        "id" : "Condition.bodySite.extension:laterality",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "laterality",
        "definition" : "Body side of the body location, if needed to distinguish from a similar location on the other side of the body.\n\nThe laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.bodySite.extension:anatomicalorientation",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "anatomicalorientation",
        "definition" : "AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation.\nThe orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.bodySite.extension:relationtolandmark",
        "path" : "Condition.bodySite.extension",
        "sliceName" : "relationtolandmark",
        "definition" : "The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by:\n* Specifying the location and type of landmark using a body site code and optional laterality/orientation,\n* Specifying the direction from the landmark to the body location, and\n* Specifying the distance from the landmark to the body location.\n\nThe RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.\n\n* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.\n* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.\n* Relation to landmark: The location relative to a landmark is specified by:\n1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and\n2. Specifying the direction and distance from the landmark to the body location.\n\nNote that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"
            ]
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Condition.subject",
        "path" : "Condition.subject",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"
            ]
          }
        ]
      },
      {
        "id" : "Condition.encounter",
        "path" : "Condition.encounter",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
            ]
          }
        ]
      },
      {
        "id" : "Condition.recorder",
        "path" : "Condition.recorder",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole",
              "http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
            ]
          }
        ]
      },
      {
        "id" : "Condition.asserter",
        "path" : "Condition.asserter",
        "short" : "The information comes from a practitioner who asserts the condition",
        "definition" : "The information comes from a practitioner who asserts the condition.",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
            ]
          }
        ]
      },
      {
        "id" : "Condition.stage",
        "path" : "Condition.stage",
        "min" : 0,
        "max" : "1"
      },
      {
        "id" : "Condition.stage.assessment",
        "path" : "Condition.stage.assessment",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-CancerStageGroup"
            ]
          }
        ]
      },
      {
        "id" : "Condition.evidence",
        "path" : "Condition.evidence"
      },
      {
        "id" : "Condition.evidence.code",
        "path" : "Condition.evidence.code",
        "binding" : {
          "strength" : "example",
          "valueSet" : "http://hl7.org/fhir/ValueSet/clinical-findings"
        }
      }
    ]
  }
}