CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1 United States of America flag

This page is part of the CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PatientsOfInterestList - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the poi-list resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. List
Definition

A list is a curated collection of resources.

Short A list is a curated collection of resources
Control 0..*
Is Modifier false
Summary false
Alternate Names Collection, WorkingList, Organizer
Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
2. List.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1
Type uri
Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. List.extension
Definition

An Extension


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

Short ExtensionAdditional content defined by implementations
Comments

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.

Control 0..*
Type Extension
Is Modifier false
Summary false
Alternate Names extensions, user content
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing This element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. List.extension:patient-list-applicable-period
    Slice Name patient-list-applicable-period
    Definition

    An extension used to indicate the reporting period associated with the census List.

    Short The reporting period associated with the patients of interest List
    Control 0..1
    This element is affected by the following invariants: ele-1
    Type Extension(Patient List Applicable Period) (Extension Type: Period)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. List.modifierExtension
    Definition

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

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    Short Extensions that cannot be ignored
    Comments

    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.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summary false
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. List.identifier
    Definition

    Identifier for the List assigned for business purposes outside the context of FHIR.

    Short Business identifier
    Note This is a business identifier, not a resource identifier (see discussion)
    Control 10..*
    Type Identifier
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. List.status
    Definition

    Indicates the current state of this list.

    Short current | retired | entered-in-error
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control 1..1
    Binding The codes SHALL be taken from ListStatushttp://hl7.org/fhir/ValueSet/list-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/list-status|4.0.1)

    The current state of the list.

    Type code
    Is Modifier true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. List.mode
    Definition

    How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

    Short working | snapshot | changes
    Comments

    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

    Control 1..1
    Binding The codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

    The processing mode that applies to this list.

    Type code
    Is Modifier true because If set to "changes", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Requirements

    Lists are used in various ways, and it must be known in what way it is safe to use them.

    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. List
    2. List.meta
    4. List.meta.extension:link-received-date-extension
    Slice Name link-received-date-extension
    Control 0..1
    Type Extension(Received Date) (Extension Type: dateTime)
    6. List.extension
    Slicing This element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 8. List.extension:patient-list-applicable-period
      Slice Name patient-list-applicable-period
      Short The reporting period associated with the patients of interest List
      Control 0..1
      Type Extension(Patient List Applicable Period) (Extension Type: Period)
      10. List.identifier
      Note This is a business identifier, not a resource identifier (see discussion)
      Control 1..?
      12. List.entry
      14. List.entry.item
      Short Patient Of Interest reference
      Type Reference(US Core Patient Profile)

      Guidance on how to interpret the contents of this table can be foundhere

      0. List
      Definition

      A list is a curated collection of resources.

      Short A list is a curated collection of resources
      Control 0..*
      Is Modifier false
      Summary false
      Alternate Names Collection, WorkingList, Organizer
      Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
      lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
      lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
      2. List.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      Short Logical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control 0..1
      Type id
      Is Modifier false
      Summary true
      4. List.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      Short Metadata about the resource
      Control 0..1
      Type Meta
      Is Modifier false
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. List.meta.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      Short Unique id for inter-element referencing
      Control 0..1
      Type string
      Is Modifier false
      XML Format In the XML format, this property is represented as an attribute.
      Summary false
      8. List.meta.extension
      Definition

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

      Short Additional content defined by implementations
      Comments

      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.

      Control 0..*
      Type Extension
      Is Modifier false
      Summary false
      Alternate Names extensions, user content
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      Slicing This element introduces a set of slices on List.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. List.meta.extension:link-received-date-extension
        Slice Name link-received-date-extension
        Definition

        This extension stores the date and time a Resource was received by the processing system (e.g. NHSNLink).

        Short Received Date
        Control 0..1
        Type Extension(Received Date) (Extension Type: dateTime)
        Is Modifier false
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. List.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        Short Version specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control 0..1
        Type id
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. List.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        Short When the resource version last changed
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. List.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        Short Identifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. List.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        Short Profiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control 0..*
        Type canonical(StructureDefinition)
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. List.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        Short Security Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control 0..*
        Binding Unless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

        Security Labels from the Healthcare Privacy and Security Classification System.

        Type Coding
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. List.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        Short Tags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control 0..*
        Binding For example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        Type Coding
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. List.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        Short A set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control 0..1
        Type uri
        Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. List.language
        Definition

        The base language in which the resource is written.

        Short Language of the resource content
        Comments

        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).

        Control 0..1
        Binding The codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

        A human language.

        Additional Bindings Purpose
        AllLanguages Max Binding
        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. List.text
        Definition

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

        Short Text summary of the resource, for human interpretation
        Comments

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

        Control 0..1
        Type Narrative
        Is Modifier false
        Summary false
        Alternate Names narrative, html, xhtml, display
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. List.contained
        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.

        Short Contained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control 0..*
        Type Resource
        Is Modifier false
        Summary false
        Alternate Names inline resources, anonymous resources, contained resources
        32. List.extension
        Definition

        An Extension

        Short Extension
        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        Slicing This element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 34. List.extension:patient-list-applicable-period
          Slice Name patient-list-applicable-period
          Definition

          An extension used to indicate the reporting period associated with the census List.

          Short The reporting period associated with the patients of interest List
          Control 0..1
          This element is affected by the following invariants: ele-1
          Type Extension(Patient List Applicable Period) (Extension Type: Period)
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          36. List.modifierExtension
          Definition

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

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          Short Extensions that cannot be ignored
          Comments

          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.

          Control 0..*
          Type Extension
          Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summary false
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Names extensions, user content
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          38. List.identifier
          Definition

          Identifier for the List assigned for business purposes outside the context of FHIR.

          Short Business identifier
          Note This is a business identifier, not a resource identifier (see discussion)
          Control 1..*
          Type Identifier
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. List.status
          Definition

          Indicates the current state of this list.

          Short current | retired | entered-in-error
          Comments

          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

          Control 1..1
          Binding The codes SHALL be taken from ListStatus
          (required to http://hl7.org/fhir/ValueSet/list-status|4.0.1)

          The current state of the list.

          Type code
          Is Modifier true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. List.mode
          Definition

          How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Short working | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control 1..1
          Binding The codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this list.

          Type code
          Is Modifier true because If set to "changes", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Requirements

          Lists are used in various ways, and it must be known in what way it is safe to use them.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. List.title
          Definition

          A label for the list assigned by the author.

          Short Descriptive name for the list
          Control 0..1
          Type string
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Requirements

          Allows customization beyond just the code identifying the kind of list.

          Example General: Dr. Jane's Patients
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. List.code
          Definition

          This code defines the purpose of the list - why it was created.

          Short What the purpose of this list is
          Comments

          If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.

          Control 0..1
          Binding For example codes, see ExampleUseCodesForList
          (example to http://hl7.org/fhir/ValueSet/list-example-codes|4.0.1)

          What the purpose of a list is.

          Type CodeableConcept
          Is Modifier false
          Summary true
          Requirements

          Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. List.subject
          Definition

          The common subject (or patient) of the resources that are in the list if there is one.

          Short If all resources have the same subject
          Comments

          Some purely arbitrary lists do not have a common subject, so this is optional.

          Control 0..1
          Type Reference(Patient, Group, Device, Location)
          Is Modifier false
          Summary true
          Requirements

          The primary purpose of listing the subject explicitly is to help with finding the right list.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. List.encounter
          Definition

          The encounter that is the context in which this list was created.

          Short Context in which list created
          Control 0..1
          Type Reference(Encounter)
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. List.date
          Definition

          The date that the list was prepared.

          Short When the list was prepared
          Comments

          The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

          Control 0..1
          Type dateTime
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Requirements

          Identifies how current the list is which affects relevance.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. List.source
          Definition

          The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

          Short Who and/or what defined the list contents (aka Author)
          Comments

          The primary source is the entity that made the decisions what items are in the list. This may be software or user.

          Control 0..1
          Type Reference(Practitioner, PractitionerRole, Patient, Device)
          Is Modifier false
          Summary true
          Requirements

          Allows follow-up as well as context.

          Alternate Names Author
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. List.orderedBy
          Definition

          What order applies to the items in the list.

          Short What order the list has
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control 0..1
          Binding The codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order|4.0.1)

          What order applies to the items in a list.

          Type CodeableConcept
          Is Modifier false
          Summary false
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. List.note
          Definition

          Comments that apply to the overall list.

          Short Comments about the list
          Control 0..*
          Type Annotation
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. List.entry
          Definition

          Entries in this list.

          Short Entries in the list
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control 0..*
          This element is affected by the following invariants: lst-1
          Type BackboneElement
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. List.entry.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          Short Unique id for inter-element referencing
          Control 0..1
          Type string
          Is Modifier false
          XML Format In the XML format, this property is represented as an attribute.
          Summary false
          64. List.entry.extension
          Definition

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

          Short Additional content defined by implementations
          Comments

          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.

          Control 0..*
          Type Extension
          Is Modifier false
          Summary false
          Alternate Names extensions, user content
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          66. List.entry.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          Short Extensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control 0..*
          Type Extension
          Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summary true
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Names extensions, user content, modifiers
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          68. List.entry.flag
          Definition

          The flag allows the system constructing the list to indicate the role and significance of the item in the list.

          Short Status/Workflow information about this item
          Comments

          The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

          Control 0..1
          Binding For example codes, see PatientMedicineChangeTypes
          (example to http://hl7.org/fhir/ValueSet/list-item-flag|4.0.1)

          Codes that provide further information about the reason and meaning of the item in the list.

          Type CodeableConcept
          Is Modifier false
          Summary false
          Requirements

          This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. List.entry.deleted
          Definition

          True if this item is marked as deleted in the list.

          Short If this item is actually marked as deleted
          Comments

          If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

          Control 0..1
          This element is affected by the following invariants: lst-2
          Type boolean
          Is Modifier true because If deleted is true, then the item included in the list isn't actually part of the list anymore
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary false
          Requirements

          The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

          Meaning if Missing List items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. List.entry.date
          Definition

          When this item was added to the list.

          Short When item added to list
          Control 0..1
          Type dateTime
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary false
          Requirements

          The date may be significant for understanding the meaning of items in a working list.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. List.entry.item
          Definition

          A reference to the actual resource from which data was derived.

          Short Patient Of Interest reference
          Control 1..1
          Type Reference(US Core Patient Profile)
          Is Modifier false
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. List.emptyReason
          Definition

          If the list is empty, why the list is empty.

          Short Why list is empty
          Comments

          The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control 0..1
          This element is affected by the following invariants: lst-1
          Binding The codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1)

          If a list is empty, why it is empty.

          Type CodeableConcept
          Is Modifier false
          Summary false
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))