Composition Profile

Canonical	../StructureDefinition/nexus-emr-core-composition
Status	draft · 1.26.0
Base	Composition (constraint)
Source	FSH · JSON

Nexus EMR profile for an AUTHORED clinical note -- principally the encounter note (progress note, consult note, telephone note) written by an EMR user or drafted by an AI scribe and attested by a clinician.

Examples

AI Pre-Visit Summary (cited document) · Progress Note - 8 Apr 2025 · Referral - Internal Medicine - Avery Linwood · Signed Encounter Note (extraction source) · Since last visit - Avery Linwood · Since last visit - Avery Linwood (converted) · Telephone Note - 20 May 2025 (amended)

Since last visit - Avery Linwood (converted)

Composition/converted-summary-oscar-11488-4 — claims conformance to Composition Profile

{
  "resourceType": "Composition",
  "id": "converted-summary-oscar-11488-4",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-composition"
    ]
  },
  "status": "final",
  "type": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "34133-9",
        "display": "Summary of Episode Note"
      }
    ],
    "text": "casemgmt_note (converted)"
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "11488-4",
          "display": "Consult Note"
        }
      ]
    }
  ],
  "subject": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "date": "2025-05-20T07:00:00-06:00",
  "author": [
    {
      "type": "Device",
      "identifier": {
        "system": "../NamingSystem/nexus-harness-graph",
        "value": "chart-summary"
      },
      "display": "ChartSummary graph (AI)"
    }
  ],
  "title": "Since last visit - Avery Linwood (converted)",
  "event": [
    {
      "period": {
        "start": "2025-04-08T09:00:00-06:00",
        "end": "2025-05-20T07:00:00-06:00"
      }
    }
  ],
  "section": [
    {
      "title": "Since last visit",
      "text": {
        "status": "generated",
        "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p>This example exists to pin two things the other Composition examples cannot.</p><p><b>The classifier is <code>category</code>, not <code>type</code>.</b> This profile's guidance says so explicitly, and says why: in converted source data <code>type</code> is often a constant, because every OSCAR <code>casemgmt_note</code> arrives as LOINC 11488-4 whatever it actually is. So this summary carries 34133-9 in <code>category</code> and the source constant in <code>type</code> -- the documented shape. It is <code>final</code> and has no <code>attester</code>, and it must still pass <code>composition-signed-has-attester</code>, because nobody signs a machine-generated summary. An earlier form of that invariant required the summary code in <code>type</code> and rejected exactly this resource.</p><p><b><code>identifier</code> is absent</b>, exercising the relaxation from 1..1. A converted document has no harness business key: nothing regenerates it, so there is no key to regenerate it under.</p><p><b><code>event.period</code> carries the interval the summary covers</b> -- 8 April to 20 May -- which is what makes it datable on a clinical timeline at all. A converted note's source clinical date belongs here, not in <code>date</code>: <code>date</code> is the editing time and moves, and in converted data it is frequently just the conversion run.</p></div>"
      }
    }
  ]
}