MediRecords FHIR Implementation Guide
1.4.1 - release


Resource Profile: MR DocumentReference

Defining URL:https://fhir.medirecords.com/StructureDefinition/mr-documentreference
Version:1.4.1
Name:MRDocumentReference
Title:MR DocumentReference
Status:Active as of 2025-02-03 04:29:41+0000
Definition:

MediRecords DocumentReference base profile for Correspondence

Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

https://fhir.medirecords.com/StructureDefinition/mr-documentreference

Formal Views of Profile Content

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

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference This is an abstractprofile. Childprofiles: MRDocumentReferenceAdmission, MRDocumentReferenceAttachment, MRDocumentReferenceConsultation, MRDocumentReferenceIn, MRDocumentReferenceOut, MRDocumentReferencePrescription
A reference to a document
... meta S 0..1 MRMeta Metadata about a resource
.... lastUpdated S 0..1 instant When the resource version last changed
.... security S 0..* Coding Security Labels applied to this resource
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recipient 0..1 (Complex) MR DocumentReference Recipient Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn
..... value[x] 1..1 Reference(MR Practitioner | MR Organisation | MR Patient) Document recipient
.... documentTitle 0..1 string MR DocumentReference Title Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-title-extn
... status SC 1..1 code Indicates if document is Active(current) or Inactive(entered-in-error)
inv-mr-docref-in-status-01: MediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
... type S 0..1 CodeableConcept Kind of document (LOINC if possible)
... category S 1..1 CodeableConcept Categorization of document
... subject S 1..1 Reference(MR Patient) The patient who is the subject of the document
... date S 0..1 instant When this document reference was created
... author 0..1 Reference(MR Practitioner | MR PractitionerRole | MR Organisation) Who and/or what authored the document
... authenticator 0..1 Reference(MR Practitioner) The user from the practice who checked the document on upload
... custodian S 1..1 Reference(MR Organisation) Organization which maintains the document
... content
.... attachment
..... contentType S 0..1 code Mime type of the content, with charset etc.
..... data S 0..1 base64Binary Data inline, base64ed
..... size S 0..1 unsignedInt Number of bytes of content (if url provided)
..... title S 0..1 string The file name of the attachment
... context
.... encounter S 0..1 Reference(MR Encounter | MR Encounter Admission) Context of the document content

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference This is an abstractprofile. Childprofiles: MRDocumentReferenceAdmission, MRDocumentReferenceAttachment, MRDocumentReferenceConsultation, MRDocumentReferenceIn, MRDocumentReferenceOut, MRDocumentReferencePrescription
A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta S 0..1 MRMeta Metadata about a resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


inv-mr-meta-security-01: Medirecords supports only U, R security code
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recipient 0..1 (Complex) MR DocumentReference Recipient Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn"
..... value[x] 1..1 Reference(MR Practitioner | MR Organisation | MR Patient) Document recipient
.... documentTitle 0..1 string MR DocumentReference Title Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-title-extn
... 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 ?!SΣC 1..1 code Indicates if document is Active(current) or Inactive(entered-in-error)
Binding: DocumentReferenceStatus (required): The status of the document reference.


inv-mr-docref-in-status-01: MediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
... docStatus SΣ 0..1 code Indicates if the document is Unchecked/Draft (preliminary) or Checked/Final (final) or Amended (amended) or Cancelled/Rejected (entered-in-error)
Binding: CompositionStatus (required): Status of the underlying document.

... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject SΣ 1..1 Reference(MR Patient) The patient who is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author Σ 0..1 Reference(MR Practitioner | MR PractitionerRole | MR Organisation) Who and/or what authored the document
... authenticator 0..1 Reference(MR Practitioner) The user from the practice who checked the document on upload
... custodian S 1..1 Reference(MR Organisation) Organization which maintains the document
... relatesTo Σ 0..* BackboneElement Relationships to other documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
... description Σ 0..1 string Human-readable description
... securityLabel Σ 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ 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 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... language Σ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
..... data S 0..1 base64Binary Data inline, base64ed
..... url Σ 0..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
..... size SΣ 0..1 unsignedInt Number of bytes of content (if url provided)
..... hash Σ 0..1 base64Binary Hash of the data (sha-1, base64ed)
..... title SΣ 0..1 string The file name of the attachment
Example General: Official Corporate Logo
..... creation Σ 0..1 dateTime Date attachment was first created
.... format Σ 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ 0..1 BackboneElement Clinical context of document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... encounter S 0..1 Reference(MR Encounter | MR Encounter Admission) Context of the document content
.... event 0..* CodeableConcept Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ 0..1 Period Time of service that is being documented
.... facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).

.... sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
.... related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference This is an abstractprofile. Childprofiles: MRDocumentReferenceAdmission, MRDocumentReferenceAttachment, MRDocumentReferenceConsultation, MRDocumentReferenceIn, MRDocumentReferenceOut, MRDocumentReferencePrescription
A reference to a document
... meta 0..1 MRMeta Metadata about a resource
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... security ΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


inv-mr-meta-security-01: Medirecords supports only U, R security code
... status ?!ΣC 1..1 code Indicates if document is Active(current) or Inactive(entered-in-error)
Binding: DocumentReferenceStatus (required): The status of the document reference.


inv-mr-docref-in-status-01: MediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
... docStatus Σ 0..1 code Indicates if the document is Unchecked/Draft (preliminary) or Checked/Final (final) or Amended (amended) or Cancelled/Rejected (entered-in-error)
Binding: CompositionStatus (required): Status of the underlying document.

... category Σ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject Σ 1..1 Reference(MR Patient) The patient who is the subject of the document
... date Σ 0..1 instant When this document reference was created
... custodian 1..1 Reference(MR Organisation) Organization which maintains the document
... content Σ 1..* BackboneElement Document referenced
.... attachment Σ 1..1 Attachment Where to access the document
..... contentType Σ 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.

..... data 0..1 base64Binary Data inline, base64ed
..... size Σ 0..1 unsignedInt Number of bytes of content (if url provided)
..... title Σ 0..1 string The file name of the attachment
... context Σ 0..1 BackboneElement Clinical context of document
.... encounter 0..1 Reference(MR Encounter | MR Encounter Admission) Context of the document content

doco Documentation for this format

Differential View

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference This is an abstractprofile. Childprofiles: MRDocumentReferenceAdmission, MRDocumentReferenceAttachment, MRDocumentReferenceConsultation, MRDocumentReferenceIn, MRDocumentReferenceOut, MRDocumentReferencePrescription
A reference to a document
... meta S 0..1 MRMeta Metadata about a resource
.... lastUpdated S 0..1 instant When the resource version last changed
.... security S 0..* Coding Security Labels applied to this resource
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recipient 0..1 (Complex) MR DocumentReference Recipient Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn
..... value[x] 1..1 Reference(MR Practitioner | MR Organisation | MR Patient) Document recipient
.... documentTitle 0..1 string MR DocumentReference Title Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-title-extn
... status SC 1..1 code Indicates if document is Active(current) or Inactive(entered-in-error)
inv-mr-docref-in-status-01: MediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
... type S 0..1 CodeableConcept Kind of document (LOINC if possible)
... category S 1..1 CodeableConcept Categorization of document
... subject S 1..1 Reference(MR Patient) The patient who is the subject of the document
... date S 0..1 instant When this document reference was created
... author 0..1 Reference(MR Practitioner | MR PractitionerRole | MR Organisation) Who and/or what authored the document
... authenticator 0..1 Reference(MR Practitioner) The user from the practice who checked the document on upload
... custodian S 1..1 Reference(MR Organisation) Organization which maintains the document
... content
.... attachment
..... contentType S 0..1 code Mime type of the content, with charset etc.
..... data S 0..1 base64Binary Data inline, base64ed
..... size S 0..1 unsignedInt Number of bytes of content (if url provided)
..... title S 0..1 string The file name of the attachment
... context
.... encounter S 0..1 Reference(MR Encounter | MR Encounter Admission) Context of the document content

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference This is an abstractprofile. Childprofiles: MRDocumentReferenceAdmission, MRDocumentReferenceAttachment, MRDocumentReferenceConsultation, MRDocumentReferenceIn, MRDocumentReferenceOut, MRDocumentReferencePrescription
A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta S 0..1 MRMeta Metadata about a resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


inv-mr-meta-security-01: Medirecords supports only U, R security code
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recipient 0..1 (Complex) MR DocumentReference Recipient Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "https://fhir.medirecords.com/StructureDefinition/mr-document-ref-recipient-extn"
..... value[x] 1..1 Reference(MR Practitioner | MR Organisation | MR Patient) Document recipient
.... documentTitle 0..1 string MR DocumentReference Title Extension
URL: https://fhir.medirecords.com/StructureDefinition/mr-document-ref-title-extn
... 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 ?!SΣC 1..1 code Indicates if document is Active(current) or Inactive(entered-in-error)
Binding: DocumentReferenceStatus (required): The status of the document reference.


inv-mr-docref-in-status-01: MediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
... docStatus SΣ 0..1 code Indicates if the document is Unchecked/Draft (preliminary) or Checked/Final (final) or Amended (amended) or Cancelled/Rejected (entered-in-error)
Binding: CompositionStatus (required): Status of the underlying document.

... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject SΣ 1..1 Reference(MR Patient) The patient who is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author Σ 0..1 Reference(MR Practitioner | MR PractitionerRole | MR Organisation) Who and/or what authored the document
... authenticator 0..1 Reference(MR Practitioner) The user from the practice who checked the document on upload
... custodian S 1..1 Reference(MR Organisation) Organization which maintains the document
... relatesTo Σ 0..* BackboneElement Relationships to other documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
... description Σ 0..1 string Human-readable description
... securityLabel Σ 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ 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 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... language Σ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
..... data S 0..1 base64Binary Data inline, base64ed
..... url Σ 0..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
..... size SΣ 0..1 unsignedInt Number of bytes of content (if url provided)
..... hash Σ 0..1 base64Binary Hash of the data (sha-1, base64ed)
..... title SΣ 0..1 string The file name of the attachment
Example General: Official Corporate Logo
..... creation Σ 0..1 dateTime Date attachment was first created
.... format Σ 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ 0..1 BackboneElement Clinical context of document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... encounter S 0..1 Reference(MR Encounter | MR Encounter Admission) Context of the document content
.... event 0..* CodeableConcept Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ 0..1 Period Time of service that is being documented
.... facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).

.... sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
.... related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
DocumentReference.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DocumentReference.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.statusrequiredDocumentReferenceStatus
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
from the FHIR Standard
DocumentReference.docStatusrequiredCompositionStatus
http://hl7.org/fhir/ValueSet/composition-status|4.0.1
from the FHIR Standard
DocumentReference.typepreferredDocumentTypeValueSet
http://hl7.org/fhir/ValueSet/c80-doc-typecodes
from the FHIR Standard
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.content.formatpreferredDocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem)
http://hl7.org/fhir/ValueSet/formatcodes
from the FHIR Standard
DocumentReference.context.eventexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
http://hl7.org/fhir/ValueSet/c80-facilitycodes
from the FHIR Standard
DocumentReference.context.practiceSettingexamplePracticeSettingCodeValueSet
http://hl7.org/fhir/ValueSet/c80-practice-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDocumentReferenceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDocumentReferenceIf 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-4errorDocumentReferenceIf 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-5errorDocumentReferenceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDocumentReferenceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
inv-mr-docref-in-status-01errorDocumentReference.statusMediRecords supports only current - 'This is the current reference for this document' or entered-in-error - 'This reference was created in error'
: $this.exists() implies ($this = 'current' or $this = 'entered-in-error')
inv-mr-meta-security-01errorDocumentReference.meta.securityMedirecords supports only U, R security code
: code.exists() implies (code = 'U' or code = 'R')