MyHealth@Eu Medical Imaging Report
9.1.1 - ci-build 150

MyHealth@Eu Medical Imaging Report - Local Development build (v9.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Imaging Key Image Document Reference

Official URL: http://fhir.ehdsi.eu/imaging/StructureDefinition/keyImageDocumentReference-img-myhealtheu | Version: 9.1.1
Draft as of 2026-05-05 | Computable Name: KeyImageDocumentReferenceImgMyHealthEu

Usages:

- Refer to this Profile: Extension: HL7IDR KeyImage Finding, Extension: HL7IDR Impression and Composition Imaging MyHealth@EU

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:basedOn |  | 0..* | Reference() | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | (Complex) | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn"
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
identifier | Σ | 1..1 | AccessionNumberIdentifierEuImaging | Logical reference, when literal reference is not known
extension:modality |  | 1..1 | CodeableConcept | Imaging modality used URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.modality Binding: R5_dicom_cid_33_Modality_for_R4 (0.0.1-snapshot-2) (extensible): Type of acquired data in the instance. Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | Identifier | Other identifiers for the document Slice: Unordered, Open by value:$this
identifier:seriesInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 112002
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
identifier:sopClassInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging/CodeSystem/codesystem-missing-dicom-terminology
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 00080018
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
Slices for category | Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by profile:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:imkeyimages | Σ | 1..1 | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:keyimagecode | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 55113-5
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
subject | Σ | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
Slices for author | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document Slice: Unordered, Open by profile:$this
author:performer | Σ | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
Slices for content | Σ | 1..* | BackboneElement | Document referenced Slice: Unordered, Open by value:extension.value
content:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
content:thumbnail | Σ | 0..1 | BackboneElement | Document referenced
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: true
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
content:content | Σ | 1..1 | BackboneElement | Document referenced
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: false
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
url | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.identifier:seriesInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.category:imkeyimages | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | `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()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReferenceKeyImageEuImaging

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
Slices for extension |  |  |  | Content/Rules for all slices
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | R5 DocumentReference.basedOn | Procedure that caused this media to be created
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
subject |  | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
Slices for author |  |  |  | Content/Rules for all slices
author:performer |  | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:basedOn |  | 0..* | Reference() | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | (Complex) | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn"
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 1..1 | AccessionNumberIdentifierEuImaging | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:modality |  | 1..1 | CodeableConcept | Imaging modality used URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.modality Binding: R5_dicom_cid_33_Modality_for_R4 (0.0.1-snapshot-2) (extensible): Type of acquired data in the instance. Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
Slices for identifier | Σ | 0..* | Identifier | Other identifiers for the document Slice: Unordered, Open by value:$this
identifier:seriesInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 112002
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:sopClassInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging/CodeSystem/codesystem-missing-dicom-terminology
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 00080018
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus | Σ | 0..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | Σ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: Image Reference Type (preferred)
Slices for category | Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by profile:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:imkeyimages | Σ | 1..1 | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:keyimagecode | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 55113-5
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
date | Σ | 0..1 | instant | When this document reference was created
Slices for author | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document Slice: Unordered, Open by profile:$this
author:performer | Σ | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who/what authenticated the document
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for content | Σ | 1..* | BackboneElement | Document referenced Slice: Unordered, Open by value:extension.value
content:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
content:thumbnail | Σ | 0..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: true
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
content:content | Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: false
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data |  | 0..1 | base64Binary | Data inline, base64ed
url | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 0..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter |  | 0..* | Reference(Encounter | EpisodeOfCare) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 0..1 | Reference(Patient) | Patient demographics from source
related |  | 0..* | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.extension:basedOn/ServiceRequestOrderEuImagingaccession.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Image Reference Type | 📦1.0.0 | THO v7.1
DocumentReference.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.category:imkeyimages | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.content:thumbnail.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​attachment.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | `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()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReferenceKeyImageEuImaging

Summary

Structures

This structure refers to these other structures:

- ServiceRequest: Imaging (http://fhir.ehdsi.eu/imaging/StructureDefinition/serviceRequest-img-myhealtheu)
- Patient (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/patient-myhealtheu-core)
- PractitionerRole (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitionerRole-myhealtheu-core)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:basedOn |  | 0..* | Reference() | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | (Complex) | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn"
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
identifier | Σ | 1..1 | AccessionNumberIdentifierEuImaging | Logical reference, when literal reference is not known
extension:modality |  | 1..1 | CodeableConcept | Imaging modality used URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.modality Binding: R5_dicom_cid_33_Modality_for_R4 (0.0.1-snapshot-2) (extensible): Type of acquired data in the instance. Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | Identifier | Other identifiers for the document Slice: Unordered, Open by value:$this
identifier:seriesInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 112002
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
identifier:sopClassInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging/CodeSystem/codesystem-missing-dicom-terminology
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 00080018
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
Slices for category | Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by profile:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:imkeyimages | Σ | 1..1 | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:keyimagecode | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 55113-5
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
subject | Σ | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
Slices for author | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document Slice: Unordered, Open by profile:$this
author:performer | Σ | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
Slices for content | Σ | 1..* | BackboneElement | Document referenced Slice: Unordered, Open by value:extension.value
content:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
content:thumbnail | Σ | 0..1 | BackboneElement | Document referenced
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: true
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
content:content | Σ | 1..1 | BackboneElement | Document referenced
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: false
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
url | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.identifier:seriesInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.category:imkeyimages | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | `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()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from DocumentReferenceKeyImageEuImaging

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
Slices for extension |  |  |  | Content/Rules for all slices
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | R5 DocumentReference.basedOn | Procedure that caused this media to be created
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
subject |  | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
Slices for author |  |  |  | Content/Rules for all slices
author:performer |  | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReferenceKeyImageEuImaging | A reference to a document
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:basedOn |  | 0..* | Reference() | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
extension:basedOn/ServiceRequestOrderEuImagingaccession |  | 0..* | (Complex) | Procedure that caused this media to be created URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.basedOn"
value[x] |  | 0..1 | Reference(ServiceRequest: Imaging) | Procedure that caused this media to be created
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 1..1 | AccessionNumberIdentifierEuImaging | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:modality |  | 1..1 | CodeableConcept | Imaging modality used URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.modality Binding: R5_dicom_cid_33_Modality_for_R4 (0.0.1-snapshot-2) (extensible): Type of acquired data in the instance. Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
Slices for identifier | Σ | 0..* | Identifier | Other identifiers for the document Slice: Unordered, Open by value:$this
identifier:seriesInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 112002
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:sopClassInstanceUid | Σ | 0..1 | Identifier | Other identifiers for the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging/CodeSystem/codesystem-missing-dicom-terminology
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 00080018
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus | Σ | 0..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | Σ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: Image Reference Type (preferred)
Slices for category | Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by profile:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:imkeyimages | Σ | 1..1 | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:keyimagecode | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 55113-5
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient (Core)) | Who/what is the subject of the document
date | Σ | 0..1 | instant | When this document reference was created
Slices for author | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document Slice: Unordered, Open by profile:$this
author:performer | Σ | 0..* | Reference(PractitionerRole (Core)) | Who and/or what authored the document
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who/what authenticated the document
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for content | Σ | 1..* | BackboneElement | Document referenced Slice: Unordered, Open by value:extension.value
content:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
content:thumbnail | Σ | 0..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: true
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
content:content | Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:thumbnail |  | 1..1 | (Complex) | Thumbnail state URL: http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/documentreference-thumbnail"
value[x] |  | 1..1 | boolean | Value of extension Required Pattern: false
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data |  | 0..1 | base64Binary | Data inline, base64ed
url | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context | Σ | 0..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter |  | 0..* | Reference(Encounter | EpisodeOfCare) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 0..1 | Reference(Patient) | Patient demographics from source
related |  | 0..* | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.extension:basedOn/ServiceRequestOrderEuImagingaccession.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:seriesInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier:sopClassInstanceUid.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Image Reference Type | 📦1.0.0 | THO v7.1
DocumentReference.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.category:imkeyimages | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.content:thumbnail.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​attachment.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.content:content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | 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 | `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()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DocumentReferenceKeyImageEuImaging

Summary

Structures

This structure refers to these other structures:

- ServiceRequest: Imaging (http://fhir.ehdsi.eu/imaging/StructureDefinition/serviceRequest-img-myhealtheu)
- Patient (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/patient-myhealtheu-core)
- PractitionerRole (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitionerRole-myhealtheu-core)

Other representations of profile: CSV, Excel, Schematron