# description
This Immunization Resource describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.

# copyright
Copyright © 2016 HL7 UK  Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0  Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.  HL7® FHIR® standard Copyright © 2011+ HL7  The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html

# snapshot.element[].definition
Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.

# snapshot.element[].constraint[].human
If the resource is contained in another resource, it SHALL NOT contain nested Resources

# snapshot.element[].constraint[].human
If the resource is contained in another resource, it SHALL NOT contain any narrative

# snapshot.element[].constraint[].human
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated

# snapshot.element[].constraint[].human
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource

# snapshot.element[].constraint[].human
If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.

# snapshot.element[].constraint[].human
If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present

# snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
A set of rules under which this content was created

# snapshot.element[].definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

# snapshot.element[].comment
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.   This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The base language in which the resource is written.

# snapshot.element[].comment
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Text summary of the resource, for human interpretation

# snapshot.element[].definition
A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

# snapshot.element[].comment
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

# snapshot.element[].comment
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Was a parent present at the Immunization

# snapshot.element[].definition
Was a parent present at the Immunization.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
The date that the Vaccination was recorded

# snapshot.element[].definition
The date that the event was recorded on the system.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
An extension to hold an immunization procedure code

# snapshot.element[].definition
An extension to hold an immunization procedure code.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A unique identifier assigned to this immunization record.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
usual | official | temp | secondary (If known)

# snapshot.element[].comment
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

# snapshot.element[].requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
Identifies the purpose for this identifier, if known .

# snapshot.element[].definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

# snapshot.element[].comment
This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

# snapshot.element[].requirements
Allows users to make use of identifiers when the identifier system is not known.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

# snapshot.element[].requirements
There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

# snapshot.element[].example[].valueUri
http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.

# snapshot.element[].comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)

# snapshot.element[].short
Time period when id is/was valid for use

# snapshot.element[].definition
Time period during which identifier is/was valid for use.

# snapshot.element[].comment
This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
If present, start SHALL have a lower value than end

# snapshot.element[].constraint[].expression
start.empty() or end.empty() or (start <= end)

# snapshot.element[].mapping[].map
IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

# snapshot.element[].mapping[].map
Role.effectiveTime or implied by context

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The start of the period. The boundary is inclusive.

# snapshot.element[].comment
If the low element is missing, the meaning is that the low boundary is not known.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
End time with inclusive boundary, if not ongoing

# snapshot.element[].definition
The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

# snapshot.element[].comment
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

# snapshot.element[].meaningWhenMissing
If the end of the period is missing, it means that the period is ongoing

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Organization that issued id (may be just text)

# snapshot.element[].definition
Organization that issued/manages the identifier.

# snapshot.element[].comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].mapping[].map
II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Indicates the current status of the vaccination event.

# snapshot.element[].comment
Will generally be set to show that the immunization has been completed.  This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
A set of codes indicating the current status of an Immunization

# snapshot.element[].definition
Indicates if the vaccination was or was not given.

# snapshot.element[].comment
This element is labeled as a modifier because it indicates that an immunization didn't happen.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Vaccine that was administered or was to be administered.

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The code for vaccine product administered

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
The patient who either received or did not receive the immunization.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Date vaccine administered or was to be administered.

# snapshot.element[].comment
When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Indicates context the data was recorded in

# snapshot.element[].definition
An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

# snapshot.element[].comment
Reflects the “reliability” of the content.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Indicates the source of a secondarily reported record

# snapshot.element[].definition
The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

# snapshot.element[].comment
Should not be populated if primarySource = True, will not be required even if primarySource = False.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The source of the data for a record which is not from a primary source.

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
The service delivery location where the vaccine administration occurred.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].mapping[].map
RXA-27  (or RXA-11, deprecated as of v2.7)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Body site where vaccine was administered.

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The site at which the vaccine was administered

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
The SNOMED CT Description ID for the display

# snapshot.element[].definition
The SNOMED CT Description ID for the display.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
The path by which the vaccine product is taken into the body.

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The route by which the vaccine was administered

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
The SNOMED CT Description ID for the display

# snapshot.element[].definition
The SNOMED CT Description ID for the display.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
The quantity of vaccine product that was administered.

# snapshot.element[].comment
The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
If a code for the unit is present, the system SHALL also be present

# snapshot.element[].constraint[].human
The comparator is not used on a SimpleQuantity

# snapshot.element[].mapping[].map
PQ, IVL<PQ>, MO, CO, depending on the values

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Numerical value (with implicit precision)

# snapshot.element[].definition
The value of the measured amount. The value includes an implicit precision in the presentation of the value.

# snapshot.element[].comment
The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

# snapshot.element[].requirements
Precision is handled implicitly in almost all cases of measurement.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

# snapshot.element[].short
< | <= | >= | > - how to understand the value

# snapshot.element[].comment
This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.

# snapshot.element[].requirements
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

# snapshot.element[].meaningWhenMissing
If there is no comparator, then there is no modification of the value

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
How the Quantity should be understood and represented.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The identification of the system that provides the coded form of the unit.

# snapshot.element[].requirements
Need to know the system that defines the coded form of the unit.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A computer processable form of the unit in some unit representation system.

# snapshot.element[].comment
The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.

# snapshot.element[].requirements
Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Indicates who or what performed the event.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
Describes the type of performance (e.g. ordering provider, administering provider, etc.).

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The role a practitioner plays in the immunization event

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
The device, practitioner, etc. who performed the action.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Extra information about the immunization that is not conveyed by the other attributes.

# snapshot.element[].comment
For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Individual responsible for the annotation

# snapshot.element[].definition
The individual responsible for making the annotation.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
Indicates when this particular annotation was made.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Reasons why a vaccine was or was not administered.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The reason why a vaccine was administered

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
Reason why a vaccine was not administered.

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The reason why a vaccine was not administered

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].short
Details of a reaction that follows immunization

# snapshot.element[].definition
Categorical data indicating that an adverse event is associated in time to an immunization.

# snapshot.element[].comment
A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
(no such concept seems to exist for allergy/adverse reaction in HL7 v2)

# snapshot.element[].definition
Contains information about the protocol(s) under which the vaccine was administered.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
(HL7 v2 doesn't seem to provide for this)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].comment
32 bit number; for values larger than this, use decimal

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Contains the description about the protocol under which the vaccine was administered.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
Indicates the authority who published the protocol.  E.g. ACIP.

# snapshot.element[].comment
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
SHALL have a contained resource if a local reference is provided

# snapshot.element[].mapping[].map
The target of a resource reference is a RIM entry point (Act, Role, or Entity)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
Literal reference, Relative, internal or absolute URL

# snapshot.element[].definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

# snapshot.element[].comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Logical reference, when literal reference is not known

# snapshot.element[].definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

# snapshot.element[].comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.   When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CX / EI (occasionally, more often EI maps to a resource id or a URL)

# snapshot.element[].mapping[].map
II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]

# snapshot.element[].definition
Plain text narrative that identifies the resource in addition to the resource reference.

# snapshot.element[].comment
This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
One possible path to achieve presumed immunity against a disease - within the context of an authority.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].short
Recommended number of doses for immunity

# snapshot.element[].definition
The recommended number of doses to achieve immunity.

# snapshot.element[].comment
32 bit number; for values larger than this, use decimal

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The disease target of the vaccination protocol

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].short
The SNOMED CT Description ID for the display

# snapshot.element[].definition
The SNOMED CT Description ID for the display.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].short
Indicates if dose counts towards immunity

# snapshot.element[].definition
Indicates if the immunization event should "count" against  the protocol.

# snapshot.element[].comment
May need to differentiate between status declarations by a provider vs. a CDS engine.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The status of the vaccination protocol (i.e. should this count)

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# snapshot.element[].definition
Provides an explanation as to why an immunization event should or should not count against the protocol.

# snapshot.element[].comment
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].binding.description
The reason for the determining if a vaccination should count or why vaccination should not count.

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
A reference to a code defined by a terminology system.

# snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# snapshot.element[].requirements
Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

# snapshot.element[].definition
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# snapshot.element[].short
Additional Content defined by implementations

# snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

# snapshot.element[].comment
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# snapshot.element[].definition
The identification of the code system that defines the meaning of the symbol in the code.

# snapshot.element[].comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

# snapshot.element[].requirements
Need to be unambiguous about the source of the definition of the symbol.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

# snapshot.element[].comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to refer to a particular code in the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].definition
A representation of the meaning of the code in the system, following the rules of the system.

# snapshot.element[].comment
Note that FHIR strings may not exceed 1MB in size

# snapshot.element[].requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.2 - but note this is not well followed

# snapshot.element[].short
If this coding was chosen directly by the user

# snapshot.element[].definition
Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

# snapshot.element[].comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

# snapshot.element[].requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source "true";     fhir:target dt:CDCoding.codingRationale\#O   ]

# snapshot.element[].short
Plain text representation of the concept

# snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# snapshot.element[].requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() | (children().count() > id.count())

# snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

# differential.element[].short
The date that the Vaccination was recorded

# differential.element[].binding.description
A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.