這是對任何目的文件的參照。它提供了有關文件的metadata，以便能夠找到並管理此文件。文件的範圍包括任何具有MIME類型的序列物件(seralized object)，例如：以病人為中心的文件（CDA）、臨床註釋、掃描的紙張，以及非與病人有關的文件，像是政策文字表述。

通常，這用於除了由FHIR定義之外的文件。

構建resource時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對IG所定義之特殊規則及其他profiles的參照。

宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此URL是對IG的參照，此IG將這些特殊規則與其他profiles、value sets等一起定義為其敘述的一部分。

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).

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.

這個文件的唯一識別碼是由提供該文件的來源所賦予的。這個識別碼僅適用於該文件的特定版本。這個獨特的識別碼也可能在其他情況下用於辨認這一版本的文件

CDA 文件 Id extension及root

這個 Id 的結構和格式應與對應於 formatCode 屬性的規範一致。例如：對於 DICOM 標準文件，為64字元數字 UID；對於 HL7 CDA 格式，則為 CDA Document Id extension和 root 的序列化，格式為「oid^extension」，其中 OID 最多64位數字，Id 最多16位 UTF-8 字元。如果 OID 是不帶extension的編碼，則不應包含「^」字元。

此文件參照的狀態

DocumentReference 物件的狀態，可能與 docStatus 資料項目無關，兩者可以是獨立設定。 此資料項目被標記為修飾用(modifier)，因為狀態包含標記 resource 為當前無效的代碼。

文件參照的狀態；應填入所綁定值集中的其中一個代碼。

被參照文件的具體類型，例如是關於病人的病史和體檢報告、出院摘要、病程摘要等。這樣的類型通常與文件被創建和使用的目的是一致的。

關鍵metadata描述了文件的確切類型，有助於人們在查看文件清單時判斷該文件是否感興趣。

應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

文件的一個分類標準，用於幫助對文件進行索引和查詢。這個分類可能直接基於或是由 DocumentReference.type 指定的代碼來確定。

關鍵metadata描述文件的大類或類型。這種分類是基於文件可能的用途或功能，將具有相似用途的文件劃分為同一組。在進行文件查詢時，這個分類作為一個主要的查詢條件。

應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

文件可能涉及的對象範圍。這意味著文件可能描述的是一個人（例如病人或健康照護服務提供者）、一個設備（比如某種醫療機構），或者是一組特定的對象，比如一群農場動物或者一批有著相同健康風險的病人。

文件參照的創建時間是何時？

文件的參照或索引時間被用於來追蹤文件的歷史、組織不同的版本及需要時查詢特定文件。

識別誰負責將資訊添加到文件中

未必是輸入資料的人（例如：打字員），也不必是提供資訊的人（例如：資訊提供者）。

參照的文件和格式。可能存在多個content資料項目，每個資料項目都有不同的格式。

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).

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.

文件或文件的URL以及證明內容具有完整性的關鍵metadata

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

The mime type of an attachment. Any valid mime type is allowed.

Processors of the data need to be able to know how to interpret the data.

A location where the data can be accessed.

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

The data needs to be transmitted by reference.

A label or set of text to display in place of the data.

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

這是對任何目的文件的參照。它提供了有關文件的metadata，以便能夠找到並管理此文件。文件的範圍包括任何具有MIME類型的序列物件(seralized object)，例如：以病人為中心的文件（CDA）、臨床註釋、掃描的紙張，以及非與病人有關的文件，像是政策文字表述。

通常，這用於除了由FHIR定義之外的文件。

resource的邏輯ID，在resource的URL中使用。一旦指定，這個值永遠不會改變。

一個resource使用新增操作（create operation）提交給伺服器時，此resource沒有id，它的id在resource被創建後由伺器分配/指定。

關於resource的metadata。這是由基礎建設維護的內容。內容的更改可能並不總是與resource的版本更改相關聯。

構建resource時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對IG所定義之特殊規則及其他profiles的參照。

宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此URL是對IG的參照，此IG將這些特殊規則與其他profiles、value sets等一起定義為其敘述的一部分。

編寫此resource的語言

提供語言是為了支援索引和可存取性（通常，文字表述轉語音等服務使用此語言標籤）。html lanuage tag適用於此敘述。resource上的語言標籤可用於指定從resource中的資料所產成的其他表述之語言。不是所有的內容都必須使用此語言。不應該假定Resource.language自動適用於敘述。如果指定語言，它也應該被指定在html中的div資料項目（關於xml:lang和html lang屬性之間的關係，見HTML5中的規則）。

人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。

人可讀的敘述，包含resource的摘要，可用於向人表述resource的內容。敘述不需要對所有的結構化資料進行編碼，但需要包含足夠的細節使人在閱讀敘述時理解「臨床安全性」。resource定義有哪些內容應該在敘述中表示，以確保臨床安全。

內嵌（contained）的resource沒有敘述，非內嵌（contained）的resource則 建議應該（SHOULD） 有敘述。有時resource可能只有文字表述，很少或沒有額外的結構化資料（只要滿足所有minOccurs=1的資料項目）。這可能出現在舊系統的資料，當資訊以 「文字表述區塊（text blob） 」的形式被取得，或者文字表述是原始輸入或說明，而編碼資訊稍後再添加。

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.

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.

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.

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.

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).

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.

這個文件的唯一識別碼是由提供該文件的來源所賦予的。這個識別碼僅適用於該文件的特定版本。這個獨特的識別碼也可能在其他情況下用於辨認這一版本的文件

CDA 文件 Id extension及root

這個 Id 的結構和格式應與對應於 formatCode 屬性的規範一致。例如：對於 DICOM 標準文件，為64字元數字 UID；對於 HL7 CDA 格式，則為 CDA Document Id extension和 root 的序列化，格式為「oid^extension」，其中 OID 最多64位數字，Id 最多16位 UTF-8 字元。如果 OID 是不帶extension的編碼，則不應包含「^」字元。

與文件相關的其他識別碼，包括不分版本的識別碼。

此文件參照的狀態

DocumentReference 物件的狀態，可能與 docStatus 資料項目無關，兩者可以是獨立設定。 此資料項目被標記為修飾用(modifier)，因為狀態包含標記 resource 為當前無效的代碼。

文件參照的狀態；應填入所綁定值集中的其中一個代碼。

基礎文件的狀態

被參照的文件可能會處在不同的階段或狀態中，例如初稿、完稿等不同的生命週期階段。

基礎文件的狀態；應填入所綁定值集中的其中一個代碼。

被參照文件的具體類型，例如是關於病人的病史和體檢報告、出院摘要、病程摘要等。這樣的類型通常與文件被創建和使用的目的是一致的。

關鍵metadata描述了文件的確切類型，有助於人們在查看文件清單時判斷該文件是否感興趣。

應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

文件的一個分類標準，用於幫助對文件進行索引和查詢。這個分類可能直接基於或是由 DocumentReference.type 指定的代碼來確定。

關鍵metadata描述文件的大類或類型。這種分類是基於文件可能的用途或功能，將具有相似用途的文件劃分為同一組。在進行文件查詢時，這個分類作為一個主要的查詢條件。

應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

文件可能涉及的對象範圍。這意味著文件可能描述的是一個人（例如病人或健康照護服務提供者）、一個設備（比如某種醫療機構），或者是一組特定的對象，比如一群農場動物或者一批有著相同健康風險的病人。

文件參照的創建時間是何時？

文件的參照或索引時間被用於來追蹤文件的歷史、組織不同的版本及需要時查詢特定文件。

識別誰負責將資訊添加到文件中

未必是輸入資料的人（例如：打字員），也不必是提供資訊的人（例如：資訊提供者）。

哪個人或機構認證這份文件是有效的

代表在作者機構內，一位已經合法認證或證實文件的參與者。合法認證意味著一份文件已經被法律認證人手動或電子簽章。

負責文件持續維護和存取的機構或團體

為了找到文件的最新版本或是報告問題等，需要知道哪個組織（可能是某個軟體系統、供應商或部門）負責。這與文件實際存儲的實體位置（如網路地址、硬碟或伺服器）是不同的。實體位置指的是文件存放的地方，這個位置可能被授權給其他組織來進行管理。簡單來說，就是指明負責文件更新和問題反饋的機構，和文件存放位置之間的區別。

此文件與已經存在的其他文件參照之間的關係

這個資料項目被標記為修飾用(modifier)，因為附加到其他文件上的文件本身是不完整的。

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

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.

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.

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).

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.

此文件與另一文件的關係類型

如果此文件是對另一份文件進行附加，那麼不存取被參照的文件，此文件就無法被完全理解。

文件之間的關係類型；應填入所綁定值集中的其中一個代碼。

存在此關係的目標文件

來源文件的人可讀描述

文件的內容簡介，提供了一個關於文件主要內容的簡明扼要的總結。

有助於人們判斷文件是否具有興趣價值

在文件的參照資訊中，會使用一系列的安全標籤代碼來指明該文件的隱私和安全等級。其中，DocumentReference.meta.security 用來表示參照這份文件本身的安全標籤，也就是說明參照資訊的安全等級；而 DocumentReference.securityLabel 則展示了被參照文件在那一刻的安全標籤狀態，即原始文件的安全等級。簡單來說，就是有兩種標籤，一種用於標示參照的安全性，另一種用於顯示原文件的安全性。

一種用於文件共享環境中的安全性和隱私標籤系統，即HL7醫療隱私和安全分類系統（HCS）。這套系統包括多種與文件保密性、敏感度、資料完整性和特定處理要求相關的標籤或代碼，這些代碼有的是通用的，有的則可能是特定於某一機構或項目的。雖然這套系統被推薦使用於如XDS Affinity Domain這樣的政策領域中，但具體是否採用，以及如何採用，則取決於該領域的管理政策和規範。簡言之，這是一套幫助確定文件如何被標記和處理的標籤系統，但使用與否由各自的政策領域決定。

應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.

參照的文件和格式。可能存在多個content資料項目，每個資料項目都有不同的格式。

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

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.

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.

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).

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.

文件或文件的URL以及證明內容具有完整性的關鍵metadata

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

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.

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.

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

The mime type of an attachment. Any valid mime type is allowed.

Processors of the data need to be able to know how to interpret the data.

The human language of the content. The value can be any valid value according to BCP 47.

A human language.

Users need to be able to choose between the languages in a set of attachments.

The actual data of the attachment - a sequence of bytes, base64 encoded.

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

The data needs to able to be transmitted inline.

A location where the data can be accessed.

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

The data needs to be transmitted by reference.

The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

The calculated hash of the data using SHA-1. Represented using base64.

The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

A label or set of text to display in place of the data.

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

The date that the attachment was first created.

This is often tracked as an integrity issue for use of the attachment.

這個識別碼用來表明文件符合的編碼方式、結構和模板，這些特性是除了在 mimeType（文件類型）裡已指明的基本格式之外的部分。

請注意，雖然 IHE 通常為不同格式類型發布統一資源名稱( URN)，但並非所有文件都能透過 統一資源識別碼(URI) 來識別。

鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。

文件所涉及的臨床情境或背景

這些值主要用於幫助查詢感興趣/相關的文件而添加的

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

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.

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.

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).

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.

描述文件內容所關聯的臨床就醫事件或類型

這個代碼清單代表了正在記錄的主要臨床行為，例如：結腸鏡檢查或闌尾切除手術。在某些情況下，事件已經隱含在類型代碼中，例如在「病史和體檢報告」中，正在記錄的必然是「病史和體檢」行為。

事件可以進一步專注於類型中所隱含的行為，例如當它僅為「處置報告」，而該處置是「結腸鏡檢查」。如果包括一個或多個事件代碼，則它們不應與class或type資料項目中的值相衝突，因為這樣的衝突會導致情況變得模糊不清。

可參考所綁定值集，但此值集只是針對這個欄位的一個可能值的範例，不預期也不鼓勵使用者一定要使用此值集的代碼。

文件描述的是提供服務的時間範圍

病人接受治療的機構類型

可參考所綁定值集，但此值集只是針對這個欄位的一個可能值的範例，不預期也不鼓勵使用者一定要使用此值集的代碼。

此屬性可能提供有關創建內容的實務環境細節，通常反映了臨床專業。

此資料項目應基於一個粗略的專業實務分類系統，建議使用實務環境(Practice Setting)的分類系統，例如：LOINC中的主題領域(Subject Matter Domain)所描述的。

可參考所綁定值集，但此值集只是針對這個欄位的一個可能值的範例，不預期也不鼓勵使用者一定要使用此值集的代碼。

這是健康照護服務提供者(provider)經常依賴的重要metadata之一，他們通常會用來快速排序和/或篩選以找到特定的內容。

文件發佈時已知的病人資訊。可以是對特定版本的參照，也可以是包含在文件中的資訊。

與DocumentReference相關聯的相關識別碼或resources

可能是導致創建 DocumentReference 或參照文件的識別碼或resources