to do
HL7 International / Terminology Infrastructure
Defines and enforces the minimum expectations for publication and distribution of a concept map, typically as part of an artifact repository or implementation guide publication
A map from one set of concepts to one or more other concepts
A statement of relationships from one set of concepts to one or more other concepts - either concepts in code systems, or data element/data element concepts, or classes in class models.
Name should be usable as an identifier for the module by machine processing applications such as code generation
name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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 its narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
Contained resources do not have a 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.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
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.
Must have either extensions or value[x], not both
narrative | semi-structured | structured | executable
Defines a knowledge representation level provided by this knowledge artifact.
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 managable, 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).
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.
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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Canonical identifier for this concept map, represented as a URI (globally unique)
An absolute URI that is used to identify this concept map when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this concept map is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the concept map is stored on different servers.
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R5/resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R5/resource.html#meta) element to indicate where the current master source of the resource can be found.
Allows the concept map to be referenced by a single globally unique identifier.
URL should not contain | or # - these characters make processing canonical references problematic
Additional identifier for the concept map
A formal identifier that is used to identify this concept map when it is represented in other formats, or referenced in a specification, model, design or an instance.
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this concept map outside of FHIR, where it is not possible to use the logical URI.
Allows externally provided and/or usable business identifiers to be easily associated with the module.
The identifier that is used to identify this version of the concept map when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the concept map author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
There may be different concept map instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the concept map with the format [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](http://hl7.org/fhir/R5/resource.html#bv-format).
Indicates the mechanism used to compare versions to determine which ConceptMap is more current.
If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.
Name for this concept map (computer friendly)
A natural language name identifying the concept map. This name should be usable as an identifier for the module by machine processing applications such as code generation.
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Support human navigation and code generation.
Name for this concept map (human friendly)
A short, descriptive, user-friendly title for the concept map.
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
The status of this concept map. Enables tracking the life-cycle of the content.
Allows filtering of concept maps that are appropriate for use versus not. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
A Boolean value to indicate that this concept map is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Allows filtering of concept maps that are appropriate for use versus not.
Enables experimental content to be developed following the same lifecycle that would be used for a production-level concept map.
If absent, this resource is treated as though it is not experimental.
The date (and optionally time) when the concept map was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the concept map changes.
The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the concept map. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
Name of the publisher/steward (organization or individual)
The name of the organization or individual responsible for the release and ongoing maintenance of the concept map.
Usually an organization but may be an individual. The publisher (or steward) of the concept map is the organization or individual primarily responsible for the maintenance and upkeep of the concept map. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the concept map. This item SHOULD be populated unless the information is available from context.
Helps establish the "authority/credibility" of the concept map. May also allow for contact.
Contact details to assist a user in finding and communicating with the publisher.
May be a web site, an email address, a telephone number, etc. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
Natural language description of the concept map
A free text natural language description of the concept map from a consumer's perspective.
The description is not intended to describe the semantics of the concept map. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes.
The context that the content is intended to support
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate concept map instances.
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Assist in searching for appropriate content.
Intended jurisdiction for concept map (if applicable)
A legal or geographic region in which the concept map is intended to be used.
It may be possible for the concept map to be used in jurisdictions other than those for which it was originally designed or intended. DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)
Countries and regions within which this artifact is targeted for use.
Explanation of why this concept map is needed and why it has been designed as it has.
This element does not describe the usage of the concept map. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this concept map.
A copyright statement relating to the concept map and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the concept map.
Frequently the copyright differs between the concept map and codes that are included. The copyright statement should clearly differentiate between these when required.
Consumers must be able to determine any legal restrictions on the use of the concept map and/or its content.
A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Defines the content expected to be rendered in all representations of the artifact.
When the ConceptMap was approved by publisher
The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
The 'date' element may be more recent than the approval date because of minor changes or editorial corrections. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
When the ConceptMap was last reviewed by the publisher
The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
If specified, this date follows the original approval date. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.
When the ConceptMap is expected to be used
The period during which the ConceptMap content was or is planned to be in active use.
The effective period for a ConceptMap determines when the content is applicable for usage and is independent of publication and review dates. For example, a map intended to be used for the year 2016 might be published in 2015. See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the ConceptMap are or are expected to be used instead.
E.g. Education, Treatment, Assessment, etc
Descriptions related to the content of the ConceptMap. Topics provide a high-level categorization as well as keywords for the ConceptMap that can be useful for filtering and searching.
DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableConcept indicating the topic)
Repositories must be able to determine how to categorize the ConceptMap so that it can be found by topical and keyword searches.
An individiual or organization primarily involved in the creation and maintenance of the ConceptMap.
An individual or organization primarily responsible for internal coherence of the ConceptMap.
An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the ConceptMap.
See guidance around (not) making local changes to elements [here](http://hl7.org/fhir/R5/canonicalresource.html#localization).
An individual or organization asserted by the publisher to be responsible for officially endorsing the ConceptMap for use in some setting.
Additional documentation, citations, etc
Related artifacts such as additional documentation, justification, dependencies, bibliographic references, and predecessor and successor artifacts.
Each related artifact is either an attachment, or a reference to another resource, but not both.
A ConceptMap must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
A property defines a slot through which additional information can be provided about a map from source -> target.
Properties may be used to supply for example, mapping priority, provenance, presentation hints, flag as experimental, and additional documentation. Multiple occurrences of ConceptMap.group.element.target.property may occur for a ConceptMap.property where ConceptMap.group.element.target.property.code is the same and the values in ConceptMap.group.element.target.property.value differ.
If the property type is code, a system SHALL be specified
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Additional content defined by implementations
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 managable, 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.
Extensions that cannot be ignored even if unrecognized
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 managable, 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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Identifies the property on the mappings, and when referred to in the $translate operation
A code that is used to identify the property. The code is used internally (in ConceptMap.group.element.target.property.code) and also in the $translate operation.
Reference to the formal meaning of the property.
Why the property is defined, and/or what it conveys
A description of the property - why it is defined, and how its value might be used.
Coding | string | integer | boolean | dateTime | decimal | code
The CodeSystem from which code values come
The CodeSystem that defines the codes from which values of type ```code``` in property values.
Definition of an additional attribute to act as a data source or target
An additionalAttribute defines an additional data element found in the source or target data model where the data will come from or be mapped to. Some mappings are based on data in addition to the source data element, where codes in multiple fields are combined to a single field (or vice versa).
Additional attributes are used to define additional data elements where mapping data can be found. For an example, see [Specimen Type v2 -> SNOMED CT Mapping(conceptmap-example-specimen-type.html)
Identifies this additional attribute through this resource
A code that is used to identify this additional data attribute. The code is used internally in ConceptMap.group.element.target.dependsOn.attribute and ConceptMap.group.element.target.product.attribute.
Formal identifier for the data element referred to in this attribte
Reference to the formal definition of the source/target data element. For elements defined by the FHIR specification, or using a FHIR logical model, the correct format is {canonical-url}#{element-id}.
Why the additional attribute is defined, and/or what the data element it refers to is
A description of the additional attribute and/or the data element it refers to - why it is defined, and how the value might be used in mappings, and a discussion of issues associated with the use of the data element.
code | Coding | string | boolean | Quantity
The type of the source data contained in this concept map for this data element.
When the source or target is not content defined by FHIR, some additional application logic might be required to map from the FHIR Datatype to the externally defined content
The source value set that contains the concepts that are being mapped
Identifier for the source value set that contains the concepts that are being mapped and provides context for the mappings. Limits the scope of the map to source codes (ConceptMap.group.element code or valueSet) that are members of this value set.
Should be a version specific reference. URIs SHOULD be absolute. If there is no sourceScope or targetScope value set, there is no specified context for the map (not recommended). The sourceScope value set may select codes from either an explicit (standard or local) or implicit code system.
The target value set which provides context for the mappings
Identifier for the target value set that provides important context about how the mapping choices are made. Limits the scope of the map to target codes (ConceptMap.group.element.target code or valueSet) that are members of this value set.
Should be a version specific reference. URIs SHOULD be absolute. If there is no sourceScope or targetScope value set, there is no specified context for the map (not recommended). The targetScope value set may select codes from either an explicit (standard or local) or implicit code system.
A group of mappings that all have the same source and target system.
Source system where concepts to be mapped are defined
An absolute URI that identifies the source system where the concepts to be mapped are defined.
This is not needed if the source value set is specified and it contains concepts from only a single system.
Target system that the concepts are to be mapped to
An absolute URI that identifies the target system that the concepts will be mapped to.
This is not needed if the target value set is specified and it contains concepts from only a single system. The group target may also be omitted if all of the target element relationship values are 'not-related-to'.
Mappings for a concept from the source set
Mappings for an individual concept in the source to one or more concepts in the target.
Generally, the ideal is that there would only be one mapping for each concept in the source value set, but a given concept may be mapped multiple times with different comments or dependencies.
If noMap is present, target SHALL NOT be present
(noMap.exists() and noMap=true) implies target.empty()
Either code or valueSet SHALL be present but not both.
(code.exists() and valueSet.empty()) or (code.empty() and valueSet.exists())
Identity (code or path) or the element/item being mapped.
The display for the code. The display is only provided to help editors when editing the concept map.
The display is ignored when processing the map.
Identifies the set of concepts being mapped
The set of concepts from the ConceptMap.group.source code system which are all being mapped to the target as part of this mapping rule.
If the value set expansion is empty then there are no source concepts to map in this rule.
No mapping to a target concept for this source concept
If noMap = true this indicates that no mapping to a target concept exists for this source concept.
If noMap = true, then the behavior of ConceptMap.group.unmapped (if present) does not apply.
A concept from the target value set that this concept maps to.
Ideally there would only be one map, with an 'equivalent' mapping. But multiple maps are allowed for several narrower (i.e. source-is-broader-than-target) options, or to assert that other concepts are not related.
If the map is source-is-broader-than-target or not-related-to, there SHALL be some comments, unless the status is 'draft'
comment.exists() or (%resource.status = 'draft') or relationship.empty() or ((relationship != 'source-is-broader-than-target') and (relationship != 'not-related-to'))
Identity (code or path) or the element/item that the map refers to.
The set of concepts from the ConceptMap.group.target code system which are all being mapped to as part of this mapping rule. The effect of using this data element is the same as having multiple ConceptMap.group.element.target elements with one for each concept in the ConceptMap.group.element.target.valueSet value set.
If the the value set expansion is empty then the source concept(s) are unmapped and the behavior of ConceptMap.group.unmapped (if present) applies.
related-to | equivalent | source-is-narrower-than-target | source-is-broader-than-target | not-related-to
The relationship between the source and target concepts. The relationship is read from source to target (e.g. source-is-narrower-than-target).
This element is labeled as a modifier because it may indicate that there is no mapping.
The 'not-related-to' relationship means that there is no mapping from the source to the target, and the mapping cannot be interpreted without knowing this value as it could mean the elements are equivalent, totally mismatched or anything in between
A description of status/issues in mapping that conveys additional information not represented in the structured data.
Property value for the source -> target mapping
A property value for this source -> target mapping.
A reference to a mapping property defined in ConceptMap.property.
The value of this property. If the type chosen for this element is 'code', then the property SHALL be defined in a ConceptMap.property element.
Other properties required for this mapping
A set of additional dependencies for this mapping to hold. This mapping is only applicable if the specified data attribute can be resolved, and it has the specified value.
One of value[x] or valueSet must exist, but not both.
(value.exists() and valueSet.empty()) or (value.empty() and valueSet.exists())
A reference to a mapping attribute defined in ConceptMap.additionalAttribute
A reference to the additional attribute that holds a value the map depends on.
Data element value that the map depends on / produces.
If the data type is a code, then the code system is .group.source for .dependsOn.valueCode and .group.target for .product.valueCode.
The mapping depends on a data element with a value from this value set
This mapping applies if the data element value is a code from this value set.
Other data elements that this mapping also produces
Product is the output of a ConceptMap that provides additional values that go in other attributes / data elemnts of the target data.
What to do when there is no mapping target for the source concept and ConceptMap.group.element.noMap is not true
What to do when there is no mapping to a target concept from the source concept and ConceptMap.group.element.noMap is not true. This provides the "default" to be applied when there is no target concept mapping specified or the expansion of ConceptMap.group.element.target.valueSet is empty.
The 'unmapped' element is ignored if a code is specified to have relationship = not-related-to or if ConceptMap.group.element.noMap = true.
If the mode is 'fixed', either a code or valueSet must be provided, but not both.
(mode = 'fixed') implies ((code.exists() and valueSet.empty()) or (code.empty() and valueSet.exists()))
If the mode is 'other-map', a url for the other map must be provided
(mode = 'other-map') implies otherMap.exists()
If the mode is not 'fixed', code, display and valueSet are not allowed
(mode != 'fixed') implies (code.empty() and display.empty() and valueSet.empty())
If the mode is not 'other-map', relationship must be provided
(mode != 'other-map') implies relationship.exists()
If the mode is not 'other-map', otherMap is not allowed
(mode != 'other-map') implies otherMap.empty()
Defines which action to take if there is no match for the source concept in the target system designated for the group. One of 3 actions are possible: use the unmapped source code (this is useful when doing a mapping between versions, and only a few codes have changed), use a fixed code (a default code), or alternatively, a reference to a different concept map can be provided (by canonical URL).
Defines which action to take if there is no match in the group.
The fixed code to use when the mode = 'fixed' - all unmapped codes are mapped to a single fixed code.
The set of fixed codes to use when the mode = 'fixed' - all unmapped codes are mapped to each of the fixed codes.
The default relationship value to apply between the source and target concepts when the source code is unmapped and the mode is 'fixed' or 'use-source-code'.
The default relationship value to apply between the source and target concepts when no concept mapping is specified.
canonical reference to an additional ConceptMap to use for mapping if the source concept is unmapped
The canonical reference to an additional ConceptMap resource instance to use for mapping if this ConceptMap resource contains no matching mapping for the source concept.