HL7中国FHIR Connectathon测试实施指南-文档元数据本地化定义

本指南适用于HL7中国的FHIR Connectathon测试。

Resource Profile: 文档元数据本地化定义

Defining URL:

http://hl7.org.cn/fhir/StructureDefinition/profile-documentreference-xds

Version:

V20230304

Name:

XDSDocumentReference

Title:

文档元数据本地化定义

Status:

Active as of 2023-03-04T16:13:14+08:00

Definition:

文档元数据本地化定义。

Publisher:

HL7中国

Source Resource:

XML / JSON / Turtle

本定义的正式URL为:

http://hl7.org.cn/fhir/StructureDefinition/profile-documentreference-xds

定义内容的视图

关于定义、差异、快照以及如何解读这些表示法。

文本摘要
差异表
快照表
快照表(Must Support)
All

这种结构源自 DocumentReference

Summary

Mandatory: 11 elements (1 nested mandatory element)
Must-Support: 12 elements
Prohibited: 1 element

这种结构源自 DocumentReference

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
type		1..1	CodeableConcept	文档的类型。例如，可以指明当前文档类型为20类健康档案之一 Binding: 健康档案共享文档类型代码表 (required)
category		1..1	CodeableConcept	文档的分类。包括：PHR、EHR、EMR Binding: 共享文档类别代码表 (required)
subject		1..1	Reference(Patient)	文档内记录的患者。指向患者资源
date	S	0..1	instant	该文档元数据资源的生成时间
author		1..1	Reference(Practitioner)	文档的作者。一般指代文档记录业务活动的责任医师
relatesTo	S	0..*	BackboneElement	指向其它文档，记录本文档与其它文档之间的关系。包括：替换、追加、转换、签名
securityLabel	S	0..*	CodeableConcept	记录文档的安全标签
content		1..1	BackboneElement	Document referenced
attachment
contentType	S	1..1	code	文档内容的MimeType
data		0..0
url	S	1..1	url	指向存储文档的Binary资源的地址
size	S	1..1	unsignedInt	文档的大小。原始数据的大小，而不是进行Base64算法后的值
hash	S	1..1	base64Binary	文档内容进行摘要算法的Base64编码值。摘要算法为性价比最高的SHA1
title		1..1	string	文档的标题
creation	S	1..1	dateTime	文档的生成时间
format		1..1	Coding	文档的格式，由此判定文档的处理规则 Binding: 文档处理格式代码表 (required)
context
period	S	0..1	Period	文档记录业务活动的起止时间。
start		1..1	dateTime	开始时间。
end	S	0..1	dateTime	结束时间。如果存在结束时间则必须给出。
facilityType	S	0..1	CodeableConcept	文档记录业务活动的场所类型。 Binding: 设施类型代码表 (required)
practiceSetting	S	0..1	CodeableConcept	文档记录业务活动的医学专业。 Binding: 临床医学专业代码表 (required)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	Σ	0..1	Identifier	Master Version Specific Identifier
identifier	Σ	0..*	Identifier	Other identifiers for the document
status	?!Σ	1..1	code	current \| superseded \| entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus	Σ	0..1	code	preliminary \| final \| amended \| entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type	Σ	1..1	CodeableConcept	文档的类型。例如，可以指明当前文档类型为20类健康档案之一 Binding: 健康档案共享文档类型代码表 (required)
category	Σ	1..1	CodeableConcept	文档的分类。包括：PHR、EHR、EMR Binding: 共享文档类别代码表 (required)
subject	Σ	1..1	Reference(Patient)	文档内记录的患者。指向患者资源
date	SΣ	0..1	instant	该文档元数据资源的生成时间
author	Σ	1..1	Reference(Practitioner)	文档的作者。一般指代文档记录业务活动的责任医师
authenticator		0..1	Reference(Practitioner \| PractitionerRole \| Organization)	Who/what authenticated the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	SΣ	0..*	BackboneElement	指向其它文档，记录本文档与其它文档之间的关系。包括：替换、追加、转换、签名
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces \| transforms \| signs \| appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	string	Human-readable description
securityLabel	SΣ	0..*	CodeableConcept	记录文档的安全标签 Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	Σ	1..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	1..1	code	文档内容的MimeType Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. Example General: en-AU
url	SΣ	1..1	url	指向存储文档的Binary资源的地址 Example General: http://www.acme.com/logo-small.png
size	SΣ	1..1	unsignedInt	文档的大小。原始数据的大小，而不是进行Base64算法后的值
hash	SΣ	1..1	base64Binary	文档内容进行摘要算法的Base64编码值。摘要算法为性价比最高的SHA1
title	Σ	1..1	string	文档的标题 Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	文档的生成时间
format	Σ	1..1	Coding	文档的格式，由此判定文档的处理规则 Binding: 文档处理格式代码表 (required)
context	Σ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter		0..*	Reference(Encounter \| EpisodeOfCare)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	SΣ	0..1	Period	文档记录业务活动的起止时间。
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣI	1..1	dateTime	开始时间。
end	SΣI	0..1	dateTime	结束时间。如果存在结束时间则必须给出。
facilityType	S	0..1	CodeableConcept	文档记录业务活动的场所类型。 Binding: 设施类型代码表 (required)
practiceSetting	S	0..1	CodeableConcept	文档记录业务活动的医学专业。 Binding: 临床医学专业代码表 (required)
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
date	Σ	0..1	instant	该文档元数据资源的生成时间
relatesTo	Σ	0..*	BackboneElement	指向其它文档，记录本文档与其它文档之间的关系。包括：替换、追加、转换、签名
securityLabel	Σ	0..*	CodeableConcept	记录文档的安全标签 Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	Σ	1..1	BackboneElement	Document referenced
attachment	Σ	1..1	Attachment	Where to access the document
contentType	Σ	1..1	code	文档内容的MimeType Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
url	Σ	1..1	url	指向存储文档的Binary资源的地址
size	Σ	1..1	unsignedInt	文档的大小。原始数据的大小，而不是进行Base64算法后的值
hash	Σ	1..1	base64Binary	文档内容进行摘要算法的Base64编码值。摘要算法为性价比最高的SHA1
creation	Σ	1..1	dateTime	文档的生成时间
context	Σ	0..1	BackboneElement	Clinical context of document
period	Σ	0..1	Period	文档记录业务活动的起止时间。
end	ΣI	0..1	dateTime	结束时间。如果存在结束时间则必须给出。
facilityType		0..1	CodeableConcept	文档记录业务活动的场所类型。 Binding: 设施类型代码表 (required)
practiceSetting		0..1	CodeableConcept	文档记录业务活动的医学专业。 Binding: 临床医学专业代码表 (required)
Documentation for this format

这种结构源自 DocumentReference

Summary

Mandatory: 11 elements (1 nested mandatory element)
Must-Support: 12 elements
Prohibited: 1 element

差异视图

这种结构源自 DocumentReference

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
type		1..1	CodeableConcept	文档的类型。例如，可以指明当前文档类型为20类健康档案之一 Binding: 健康档案共享文档类型代码表 (required)
category		1..1	CodeableConcept	文档的分类。包括：PHR、EHR、EMR Binding: 共享文档类别代码表 (required)
subject		1..1	Reference(Patient)	文档内记录的患者。指向患者资源
date	S	0..1	instant	该文档元数据资源的生成时间
author		1..1	Reference(Practitioner)	文档的作者。一般指代文档记录业务活动的责任医师
relatesTo	S	0..*	BackboneElement	指向其它文档，记录本文档与其它文档之间的关系。包括：替换、追加、转换、签名
securityLabel	S	0..*	CodeableConcept	记录文档的安全标签
content		1..1	BackboneElement	Document referenced
attachment
contentType	S	1..1	code	文档内容的MimeType
data		0..0
url	S	1..1	url	指向存储文档的Binary资源的地址
size	S	1..1	unsignedInt	文档的大小。原始数据的大小，而不是进行Base64算法后的值
hash	S	1..1	base64Binary	文档内容进行摘要算法的Base64编码值。摘要算法为性价比最高的SHA1
title		1..1	string	文档的标题
creation	S	1..1	dateTime	文档的生成时间
format		1..1	Coding	文档的格式，由此判定文档的处理规则 Binding: 文档处理格式代码表 (required)
context
period	S	0..1	Period	文档记录业务活动的起止时间。
start		1..1	dateTime	开始时间。
end	S	0..1	dateTime	结束时间。如果存在结束时间则必须给出。
facilityType	S	0..1	CodeableConcept	文档记录业务活动的场所类型。 Binding: 设施类型代码表 (required)
practiceSetting	S	0..1	CodeableConcept	文档记录业务活动的医学专业。 Binding: 临床医学专业代码表 (required)
Documentation for this format

快照视图

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	Σ	0..1	Identifier	Master Version Specific Identifier
identifier	Σ	0..*	Identifier	Other identifiers for the document
status	?!Σ	1..1	code	current \| superseded \| entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus	Σ	0..1	code	preliminary \| final \| amended \| entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type	Σ	1..1	CodeableConcept	文档的类型。例如，可以指明当前文档类型为20类健康档案之一 Binding: 健康档案共享文档类型代码表 (required)
category	Σ	1..1	CodeableConcept	文档的分类。包括：PHR、EHR、EMR Binding: 共享文档类别代码表 (required)
subject	Σ	1..1	Reference(Patient)	文档内记录的患者。指向患者资源
date	SΣ	0..1	instant	该文档元数据资源的生成时间
author	Σ	1..1	Reference(Practitioner)	文档的作者。一般指代文档记录业务活动的责任医师
authenticator		0..1	Reference(Practitioner \| PractitionerRole \| Organization)	Who/what authenticated the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	SΣ	0..*	BackboneElement	指向其它文档，记录本文档与其它文档之间的关系。包括：替换、追加、转换、签名
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces \| transforms \| signs \| appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	string	Human-readable description
securityLabel	SΣ	0..*	CodeableConcept	记录文档的安全标签 Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	Σ	1..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	1..1	code	文档内容的MimeType Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. Example General: en-AU
url	SΣ	1..1	url	指向存储文档的Binary资源的地址 Example General: http://www.acme.com/logo-small.png
size	SΣ	1..1	unsignedInt	文档的大小。原始数据的大小，而不是进行Base64算法后的值
hash	SΣ	1..1	base64Binary	文档内容进行摘要算法的Base64编码值。摘要算法为性价比最高的SHA1
title	Σ	1..1	string	文档的标题 Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	文档的生成时间
format	Σ	1..1	Coding	文档的格式，由此判定文档的处理规则 Binding: 文档处理格式代码表 (required)
context	Σ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter		0..*	Reference(Encounter \| EpisodeOfCare)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	SΣ	0..1	Period	文档记录业务活动的起止时间。
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣI	1..1	dateTime	开始时间。
end	SΣI	0..1	dateTime	结束时间。如果存在结束时间则必须给出。
facilityType	S	0..1	CodeableConcept	文档记录业务活动的场所类型。 Binding: 设施类型代码表 (required)
practiceSetting	S	0..1	CodeableConcept	文档记录业务活动的医学专业。 Binding: 临床医学专业代码表 (required)
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

本定义的其它表示法: Schematron

Terminology Bindings

Path	Conformance	ValueSet
DocumentReference.language	preferred	CommonLanguages Max Binding: AllLanguages
DocumentReference.status	required	DocumentReferenceStatus
DocumentReference.docStatus	required	CompositionStatus
DocumentReference.type	required	EHRDocumentType
DocumentReference.category	required	DocumentCategory
DocumentReference.relatesTo.code	required	DocumentRelationshipType
DocumentReference.securityLabel	extensible	All Security Labels
DocumentReference.content.attachment.contentType	required	Mime Types
DocumentReference.content.attachment.language	preferred	CommonLanguages Max Binding: AllLanguages
DocumentReference.content.format	required	VSDocumentFormatCode
DocumentReference.context.event	example	ActCode
DocumentReference.context.facilityType	required	VSFacilityTypeCode
DocumentReference.context.practiceSetting	required	VSPracticeSettingCode

Constraints

Id	Path	Details	Requirements
dom-2	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	DocumentReference.meta	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.implicitRules	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.language	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.text	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.masterIdentifier	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.identifier	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.status	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.docStatus	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.type	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.category	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.subject	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.date	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.author	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.authenticator	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.custodian	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.relatesTo	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.relatesTo.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.relatesTo.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.relatesTo.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.relatesTo.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.relatesTo.code	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.relatesTo.target	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.description	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.securityLabel	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.content.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.content.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.content.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.content.attachment	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.content.attachment.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.content.attachment.contentType	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.language	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.url	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.size	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.hash	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.title	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.attachment.creation	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.content.format	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.context.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.context.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.context.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.context.encounter	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.event	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.period	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.period.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	DocumentReference.context.period.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	DocumentReference.context.period.start	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.period.end	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.facilityType	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.practiceSetting	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.sourcePatientInfo	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	DocumentReference.context.related	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())