Release 4 5 Preview #2
This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Structured Documents Orders and Observations Work Group Maturity Level : N/A Standards Status : Informative Security Category : Not Classified Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Mappings for the documentreference resource (see Mappings to Other Standards for further information & status).

DocumentReference
    masterIdentifier FiveWs.identifier
    identifier FiveWs.identifier
    status FiveWs.status
    docStatus FiveWs.status
    type FiveWs.class FiveWs.what[x]
    category FiveWs.class FiveWs.what[x]
    subject FiveWs.subject[x]
    date FiveWs.recorded
    authenticator FiveWs.witness
        encounter FiveWs.context
DocumentReference Event
    masterIdentifier Event.identifier
    identifier Event.identifier
    status Event.status
    type Event.code
    subject Event.subject
    date Event.occurrence[x]
    author Event.performer.actor
    authenticator Event.performer.actor
    custodian Event.performer.actor
        encounter Event.context
DocumentReference
    masterIdentifier TXA-12
    identifier TXA-16?
    status TXA-19
    docStatus TXA-17
    type TXA-2
    category
    subject PID-3 (No standard way to define a Practitioner or Group subject in HL7 v2 MDM message)
    date
    author TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)
    authenticator TXA-10
    custodian
    relatesTo
        code
        target
    description TXA-25
    securityLabel TXA-18
    content
        attachment TXA-3 for mime type
        format
    context
        encounter
        event
        period
        facilityType
        practiceSetting
        sourcePatientInfo
        related
        basedOn
DocumentReference when describing a CDA
    masterIdentifier ClinicalDocument/id
    identifier
    status
    docStatus
    type ClinicalDocument/code/@code

The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.
    category Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code
    subject ClinicalDocument/recordTarget/
    date
    author ClinicalDocument/author
    authenticator ClinicalDocument/legalAuthenticator
    custodian
    relatesTo
        code
        target
    description
    securityLabel ClinicalDocument/confidentialityCode/@code
    content
        attachment ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date
        format derived from the IHE Profile or Implementation Guide templateID
    context
        encounter
        event
        period ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value
        facilityType usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code
        practiceSetting usually from a mapping to a local ValueSet
        sourcePatientInfo ClinicalDocument/recordTarget/
        related ClinicalDocument/relatedDocument
        basedOn
DocumentReference Document[classCode="DOC" and moodCode="EVN"]
    masterIdentifier .id
    identifier .id / .setId
    status interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
    docStatus .statusCode
    type ./code
    category .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
    subject .participation[typeCode="SBJ"].role[typeCode="PAT"]
    date .availabilityTime[type="TS"]
    author .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
    authenticator .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
    custodian .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
    relatesTo .outboundRelationship
        code .outboundRelationship.typeCode
        target .target[classCode="DOC", moodCode="EVN"].id
    description .outboundRelationship[typeCode="SUBJ"].target.text
    securityLabel .confidentialityCode
    content document.text
        attachment document.text
        format document.text
    context outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
        encounter unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
        event .code
        period .effectiveTime
        facilityType .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
        practiceSetting .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
        sourcePatientInfo .participation[typeCode="SBJ"].role[typeCode="PAT"]
        related ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct]
        basedOn .outboundRelationship[typeCode=FLFS].target
DocumentReference
    masterIdentifier DocumentEntry.uniqueId
    identifier DocumentEntry.entryUUID
    status DocumentEntry.availabilityStatus
    docStatus
    type DocumentEntry.type DocumentEntry.typeCode
    category DocumentEntry.class DocumentEntry.classCode
    subject DocumentEntry.patientId
    date
    author DocumentEntry.author
    authenticator DocumentEntry.legalAuthenticator
    custodian
    relatesTo DocumentEntry Associations
        code DocumentEntry Associations type
        target DocumentEntry Associations reference
    description DocumentEntry.comments
    securityLabel DocumentEntry.confidentialityCode
    content
        attachment DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime
        format DocumentEntry.formatCode
    context
        encounter
        event DocumentEntry.eventCodeList
        period DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime
        facilityType DocumentEntry.healthcareFacilityTypeCode
        practiceSetting DocumentEntry.practiceSettingCode
        sourcePatientInfo DocumentEntry.sourcePatientInfo, DocumentEntry.sourcePatientId
        related DocumentEntry.referenceIdList
        basedOn DocumentEntry.referenceIdList
DocumentReference when describing a Composition
    masterIdentifier Composition.identifier
    identifier
    status
    docStatus Composition.status
    type Composition.type
    category Composition.class
    subject Composition.subject
    date Composition.date
    author Composition.author
    authenticator Composition.attester
    custodian Composition.custodian
    relatesTo Composition.relatesTo
        code Composition.relatesTo.code
        target Composition.relatesTo.target
    description
    securityLabel Composition.confidentiality, Composition.meta.security
    content Bundle(Composition+*)
        attachment Composition.language,
Composition.title,
Composition.date
        format Composition.meta.profile
    context
        encounter Composition.encounter
        event Composition.event.code
        period Composition.event.period
        facilityType usually from a mapping to a local ValueSet
        practiceSetting usually from a mapping to a local ValueSet
        sourcePatientInfo Composition.subject
        related Composition.event.detail
        basedOn