DocumentReference Profile

Canonical	../StructureDefinition/nexus-emr-core-documentreference
Status	draft · 1.26.0
Base	DocumentReference (constraint)
CQL primary code path	type — what this means
Source	FSH · 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)

Hrm discharge summary 20260618

Discharge summary following a four-day admission for community-acquired pneumonia.

DocumentReference/hrm-discharge-summary-20260618 — claims conformance to DocumentReference Profile

{
  "resourceType": "DocumentReference",
  "id": "hrm-discharge-summary-20260618",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-documentreference"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p>A hospital discharge summary for Avery Linwood, delivered to the practice through HRM on 18 June 2026 and filed to the chart.</p><p>The document is held in two renditions. The first is the PDF that arrived, and it carries the <code>nexus-content-source</code> extension recording that the file came in over <code>HRM</code>. The second is a plain-text extraction produced locally from that PDF, and it carries no file metadata: it is not a delivered file, so there is no delivery channel to name. That is the rule the extension's placement on <code>content</code> exists to express -- the origin belongs to one rendition, not to the document.</p><p>How the document arrived is not recoverable from anything else here. <code>custodian</code> is the practice that now maintains the copy, and <code>author</code> is absent because the summary was written by the admitting service.</p></div>"
  },
  "status": "current",
  "type": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "18842-5",
        "display": "Discharge Summary"
      }
    ],
    "text": "Discharge summary"
  },
  "category": [
    {
      "text": "Hospital report"
    }
  ],
  "subject": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "date": "2026-06-18T09:12:00-04:00",
  "description": "Discharge summary following a four-day admission for community-acquired pneumonia.",
  "custodian": {
    "reference": "Organization/cedarbrook-clinic"
  },
  "content": [
    {
      "extension": [
        {
          "url": "../StructureDefinition/nexus-content-source",
          "extension": [
            {
              "url": "source",
              "valueString": "HRM"
            }
          ]
        }
      ],
      "attachment": {
        "contentType": "application/pdf",
        "language": "en-CA",
        "title": "Discharge Summary - June 18, 2026",
        "creation": "2026-06-18T09:12:00-04:00",
        "size": 243,
        "data": "JVBERi0xLjQKJeLjz9MKMSAwIG9iago8PAovVHlwZSAvQ2F0YWxvZwovUGFnZXMgMiAwIFIKPj4KZW5kb2JqCjIgMCBvYmoKPDwKL1R5cGUgL1BhZ2VzCi9LaWRzIFszIDAgUl0KL0NvdW50IDEKPD4KZW5kb2JqCjMgMCBvYmoKPDwKL1R5cGUgL1BhZ2UKL1BhcmVudCAyIDAgUgovTWVkaWFCb3ggWzAgMCA2MTIgNzkyXQovUmVzb3VyY2VzIDw8L0ZvbnQgPDwvRjEgNCAwIFI+Pj4+Ci9Db250ZW50cyA1IDAgUgo+PgplbmRvYmoK"
      }
    },
    {
      "attachment": {
        "contentType": "text/plain",
        "language": "en-CA",
        "title": "Discharge Summary - June 18, 2026 (text extraction)",
        "creation": "2026-06-18T09:14:00-04:00",
        "size": 204,
        "data": "RElTQ0hBUkdFIFNVTU1BUlkKT3R0YXdhIEdlbmVyYWwgSG9zcGl0YWwgLSBJbnRlcm5hbCBNZWRpY2luZQpBZG1pdHRlZCAyMDI2LTA2LTE0LCBkaXNjaGFyZ2VkIDIwMjYtMDYtMTguCkNvbW11bml0eS1hY3F1aXJlZCBwbmV1bW9uaWEsIHRyZWF0ZWQgYW5kIHJlc29sdmVkLiBGb2xsb3cgdXAgd2l0aCBmYW1pbHkgcGh5c2ljaWFuIGluIHR3byB3ZWVrcy4K"
      }
    }
  ]
}

Referenced by: Enclosures - Respirology referral letter - Avery Linwood