Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
identifier		1..1	Identifier	Número de la Evolución
status		1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
subject		0..1	Reference(Paciente)	Who and/or what the composition is about
date		1..1	dateTime	Fecha de Evolucion
author		1..*	Reference(Profesional)	Who and/or what authored the composition
attester
mode		1..1	code	personal | professional | legal | official Required Pattern: official
party		1..1	Reference(Servicio)	Who attested the composition
custodian		0..1	Reference(Establecimiento)	Organization which maintains the composition
event
code		0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period
start	S	1..1	dateTime	Fecha de Inicio
end	S	0..1	dateTime	Fecha de Final
Slices for section	S	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
code	S	1..1	CodeableConcept	Classification of section (recommended)
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:sectionMedications	S	0..1	BackboneElement	Sección sobre Medicaciones
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
entry		0..*	Reference(Documento Adjunto)	A reference to data that supports this section
section:sectionProceduresHx	S	0..1	BackboneElement	Sección sobre Procedimientos
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
entry	S	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Número de la Evolución
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
subject	Σ	0..1	Reference(Paciente)	Who and/or what the composition is about
date	Σ	1..1	dateTime	Fecha de Evolucion
author	Σ	1..*	Reference(Profesional)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
custodian	Σ	0..1	Reference(Establecimiento)	Organization which maintains the composition
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period	Σ	0..1	Period	The period covered by the documentation
start	SΣC	1..1	dateTime	Fecha de Inicio
end	SΣC	0..1	dateTime	Fecha de Final
Slices for section	SC	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
section:sectionMedications	SC	0..1	BackboneElement	Sección sobre Medicaciones
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
entry	C	0..*	Reference(Documento Adjunto)	A reference to data that supports this section
section:sectionProceduresHx	SC	0..1	BackboneElement	Sección sobre Procedimientos
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
entry	SC	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 78482-7("Oncology Progress Note")
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))
Composition.section.code	example	DocumentSectionCodes
Composition.section:sectionMedications.code	example	Pattern: LOINC code 10160-0("Hx of Medication use")
Composition.section:sectionProceduresHx.code	example	Pattern: LOINC code 47519-4("History of Procedures Document")

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	Composition	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	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	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()

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Número de la Evolución
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. 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://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: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	Σ	0..1	Reference(Paciente)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter)	Context of the Composition
date	Σ	1..1	dateTime	Fecha de Evolucion
author	Σ	1..*	Reference(Profesional)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
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
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: official
time		0..1	dateTime	When the composition was attested
party		1..1	Reference(Servicio)	Who attested the composition
custodian	Σ	0..1	Reference(Establecimiento)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/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		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
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	0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period	Σ	0..1	Period	The period covered by the documentation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Fecha de Inicio
end	SΣC	0..1	dateTime	Fecha de Final
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	SC	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section: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
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:sectionMedications	SC	0..1	BackboneElement	Sección sobre Medicaciones
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
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. 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://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: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Documento Adjunto)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:sectionProceduresHx	SC	0..1	BackboneElement	Sección sobre Procedimientos
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
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. 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://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: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	SC	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 78482-7("Oncology Progress Note")
Composition.category	example	DocumentClassValueSet
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	Pattern: official
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:sectionMedications.code	example	Pattern: LOINC code 10160-0("Hx of Medication use")
Composition.section:sectionMedications.mode	required	ListMode
Composition.section:sectionMedications.orderedBy	preferred	ListOrderCodes
Composition.section:sectionMedications.emptyReason	preferred	ListEmptyReasons
Composition.section:sectionProceduresHx.code	example	Pattern: LOINC code 47519-4("History of Procedures Document")
Composition.section:sectionProceduresHx.mode	required	ListMode
Composition.section:sectionProceduresHx.orderedBy	preferred	ListOrderCodes
Composition.section:sectionProceduresHx.emptyReason	preferred	ListEmptyReasons

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
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()

Summary

Mandatory: 4 elements (5 nested mandatory elements)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• Paciente (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosPacientePY)
• Profesional (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosProfesionalPY)
• Servicio (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosServicioPY)
• Establecimiento (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosEstablecimientoPY)
• Documento Adjunto (http://vigicanpy.mspbs.gov.py/StructureDefinition/DocumentoAdjuntoPY)

Slices

This structure defines the following Slices:

• The element Composition.section is sliced based on the value of pattern:code

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
identifier		1..1	Identifier	Número de la Evolución
status		1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
subject		0..1	Reference(Paciente)	Who and/or what the composition is about
date		1..1	dateTime	Fecha de Evolucion
author		1..*	Reference(Profesional)	Who and/or what authored the composition
attester
mode		1..1	code	personal | professional | legal | official Required Pattern: official
party		1..1	Reference(Servicio)	Who attested the composition
custodian		0..1	Reference(Establecimiento)	Organization which maintains the composition
event
code		0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period
start	S	1..1	dateTime	Fecha de Inicio
end	S	0..1	dateTime	Fecha de Final
Slices for section	S	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
code	S	1..1	CodeableConcept	Classification of section (recommended)
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:sectionMedications	S	0..1	BackboneElement	Sección sobre Medicaciones
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
entry		0..*	Reference(Documento Adjunto)	A reference to data that supports this section
section:sectionProceduresHx	S	0..1	BackboneElement	Sección sobre Procedimientos
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
entry	S	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Número de la Evolución
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
subject	Σ	0..1	Reference(Paciente)	Who and/or what the composition is about
date	Σ	1..1	dateTime	Fecha de Evolucion
author	Σ	1..*	Reference(Profesional)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
custodian	Σ	0..1	Reference(Establecimiento)	Organization which maintains the composition
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period	Σ	0..1	Period	The period covered by the documentation
start	SΣC	1..1	dateTime	Fecha de Inicio
end	SΣC	0..1	dateTime	Fecha de Final
Slices for section	SC	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
section:sectionMedications	SC	0..1	BackboneElement	Sección sobre Medicaciones
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
entry	C	0..*	Reference(Documento Adjunto)	A reference to data that supports this section
section:sectionProceduresHx	SC	0..1	BackboneElement	Sección sobre Procedimientos
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
entry	SC	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 78482-7("Oncology Progress Note")
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))
Composition.section.code	example	DocumentSectionCodes
Composition.section:sectionMedications.code	example	Pattern: LOINC code 10160-0("Hx of Medication use")
Composition.section:sectionProceduresHx.code	example	Pattern: LOINC code 47519-4("History of Procedures Document")

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	Composition	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	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	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()

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Número de la Evolución
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. 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://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: 78482-7
display		1..1	string	Representation defined by the system Fixed Value: Oncology Progress Note
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	Σ	0..1	Reference(Paciente)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter)	Context of the Composition
date	Σ	1..1	dateTime	Fecha de Evolucion
author	Σ	1..*	Reference(Profesional)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
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
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: official
time		0..1	dateTime	When the composition was attested
party		1..1	Reference(Servicio)	Who attested the composition
custodian	Σ	0..1	Reference(Establecimiento)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/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		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
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	0..*	CodeableConcept	Categoria del Tratamiento Binding: Tratamiento Oncologico (set) (required)
period	Σ	0..1	Period	The period covered by the documentation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Fecha de Inicio
end	SΣC	0..1	dateTime	Fecha de Final
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	SC	1..1	BackboneElement	Una sola sección con el detalle del tratamiento realizado Slice: Unordered, Open by pattern:code
section: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
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:sectionMedications	SC	0..1	BackboneElement	Sección sobre Medicaciones
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
title	S	1..1	string	Sección sobre Medicación Administrada
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. 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://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: 10160-0
display		1..1	string	Representation defined by the system Fixed Value: Hx of Medication use
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Documento Adjunto)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:sectionProceduresHx	SC	0..1	BackboneElement	Sección sobre Procedimientos
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
title	S	1..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. 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://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: 47519-4
display		1..1	string	Representation defined by the system Fixed Value: History of Procedures Document
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	SC	1..*	Reference(Documento Adjunto)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 78482-7("Oncology Progress Note")
Composition.category	example	DocumentClassValueSet
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	Pattern: official
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	required	ClinTratamientoOncologicoVS (a valid code from Tratamiento Oncológico (codes))
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:sectionMedications.code	example	Pattern: LOINC code 10160-0("Hx of Medication use")
Composition.section:sectionMedications.mode	required	ListMode
Composition.section:sectionMedications.orderedBy	preferred	ListOrderCodes
Composition.section:sectionMedications.emptyReason	preferred	ListEmptyReasons
Composition.section:sectionProceduresHx.code	example	Pattern: LOINC code 47519-4("History of Procedures Document")
Composition.section:sectionProceduresHx.mode	required	ListMode
Composition.section:sectionProceduresHx.orderedBy	preferred	ListOrderCodes
Composition.section:sectionProceduresHx.emptyReason	preferred	ListEmptyReasons

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:sectionMedications, Composition.section:sectionProceduresHx	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
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()

Summary

Mandatory: 4 elements (5 nested mandatory elements)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• Paciente (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosPacientePY)
• Profesional (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosProfesionalPY)
• Servicio (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosServicioPY)
• Establecimiento (http://vigicanpy.mspbs.gov.py/StructureDefinition/DatosEstablecimientoPY)
• Documento Adjunto (http://vigicanpy.mspbs.gov.py/StructureDefinition/DocumentoAdjuntoPY)

Slices

This structure defines the following Slices:

• The element Composition.section is sliced based on the value of pattern:code