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DocumentReference Profile

Canonical../StructureDefinition/nexus-emr-core-documentreference
Statusdraft · 1.26.0
BaseDocumentReference (constraint)
CQL primary code pathtype — what this means
SourceFSH · JSON

Nexus EMR profile for an ATTACHED DOCUMENT -- a clinical document that exists as a file: scanned paper, incoming faxes, external consult letters received as PDF, signed consent forms, patient-uploaded files. FHIR holds the metadata and clinical context; the bytes live in document storage and are reached through content.attachment.url.

Examples

Allergy Consult Letter (challenge refuted) · Anemia Consultation Document · Cardiology Consult Letter (received) · Consent Withdrawal Evidence Document · Hrm discharge summary 20260618 · WSIB Form 8 (filed) · WSIB Form 8 Template (with field mapping)

Anemia Consultation Document

Example document reference for anemia consultation note from April 8, 2025, carrying a reviewer's sign-off in the reviewed extension -- who acknowledged the document and when, stamped on the document itself, so a reader renders the checkmark without joining to the review task that produced it

DocumentReference/anemia-consult-20250408 — claims conformance to DocumentReference Profile

{
  "resourceType": "DocumentReference",
  "id": "anemia-consult-20250408",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-documentreference"
    ]
  },
  "extension": [
    {
      "url": "../StructureDefinition/nexus-emr-reviewed",
      "extension": [
        {
          "url": "reviewer",
          "valueReference": {
            "reference": "Practitioner/dr-emily-carter",
            "display": "Dr. Emily Carter"
          }
        },
        {
          "url": "time",
          "valueInstant": "2026-04-10T14:05:00-04:00"
        }
      ]
    }
  ],
  "status": "current",
  "type": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "11506-3",
        "display": "Progress Note"
      }
    ],
    "text": "Consult Note"
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "28570-0",
          "display": "Procedure Note"
        }
      ]
    }
  ],
  "subject": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "date": "2025-04-08T11:00:00-06:00",
  "author": [
    {
      "reference": "Practitioner/dr-emil-navarro",
      "display": "Dr. Emil Navarro"
    }
  ],
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "language": "en",
        "data": "JVBERi0xLjUKJYCBgoMKMSAwIG9iago8PC9UeXBlL0NhdGFsb2cvUGFnZXMgMiAwIFIvTGFuZyhlbi1VUykgL1N0cnVjdFRyZWVSb290IDMgMCBSL01hcmtJbmZvPDwvTWFya2VkL3RydWU+Pj4KZW5kb2JqCjIgMCBvYmoKPDwvVHlwZS9QYWdlcy9Db3VudC8xL0tpZHNbIDQgMCBSXSA+PgplbmRvYmoKMyAwIG9iago8PC9QYXJlbnRUcmVlPDw=",
        "title": "Anemia Consult Summary - April 8, 2025",
        "creation": "2025-04-08T11:00:00-06:00",
        "size": 194
      }
    }
  ],
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml">Consult note summarizing Avery Linwood's anemia diagnosis and treatment plan, authored by Dr. Emil Navarro on April 8, 2025.</div>"
  },
  "custodian": {
    "reference": "Organization/cedarbrook-clinic"
  }
}

Referenced by: AI-Drafted Note Accepted by a Clinician · Document Review Task, Completed · Enclosures - Internal Medicine referral letter - Avery Linwood · Enclosures - Respirology referral letter - Avery Linwood · nexus-privacy-directive-lockbox-named-record