A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A [Composition](/content/docs/api/fhir/resources/composition/index.html) defines the structure and narrative content necessary for a document. However, a [Composition](/content/docs/api/fhir/resources/composition/index.html) alone does not constitute a document. Rather, the [Composition](/content/docs/api/fhir/resources/composition/index.html) must be the first entry in a [Bundle](/content/docs/api/fhir/resources/bundle/index.html) where [Bundle](/content/docs/api/fhir/resources/bundle/index.html).type=document, and any other resources referenced from [Composition](/content/docs/api/fhir/resources/composition/index.html) must be included as subsequent entries in the [Bundle](/content/docs/api/fhir/resources/bundle/index.html) (for example [Patient](/content/docs/api/fhir/resources/patient/index.html), [Practitioner](/content/docs/api/fhir/resources/practitioner/index.html), [Encounter](/content/docs/api/fhir/resources/encounter/index.html), etc.).

## Elements

| Name | Required | Type | Description |
| --- | --- | --- | --- |
| identifier |  | [Identifier](/content/docs/api/fhir/datatypes/identifier/index.html) | Version-independent identifier for the Composition<br>Details<br>A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.<br>Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate. |
| status | ✓ | code | preliminary \| final \| amended \| entered-in-error<br>Details<br>The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.<br>If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. <br>Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required. |
| type | ✓ | [CodeableConcept](/content/docs/api/fhir/datatypes/codeableconcept/index.html) | Kind of composition (LOINC if possible)<br>Details<br>Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.<br>For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding. |
| category |  | [CodeableConcept](/content/docs/api/fhir/datatypes/codeableconcept/index.html)\[\] | Categorization of Composition<br>Details<br>A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.<br>This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)). |
| subject |  | Reference<Resource> | Who and/or what the composition is about<br>Details<br>Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).<br>For clinical documents, this is usually the patient. |
| encounter |  | Reference< [Encounter](/content/docs/api/fhir/resources/encounter/index.html) > | Context of the Composition<br>Details<br>Describes the clinical encounter or type of care this documentation is associated with. |
| date | ✓ | dateTime | Composition editing time<br>Details<br>The composition editing time, when the composition was last logically changed by the author.<br>The Last Modified Date on the composition may be after the date of the document was attested without being changed. |
| author | ✓ | Reference< [Practitioner](/content/docs/api/fhir/resources/practitioner/index.html)<br> \| [PractitionerRole](/content/docs/api/fhir/resources/practitionerrole/index.html)<br> \| [Device](/content/docs/api/fhir/resources/device/index.html)<br> \| [Patient](/content/docs/api/fhir/resources/patient/index.html)<br> \| [RelatedPerson](/content/docs/api/fhir/resources/relatedperson/index.html)<br> \| [Organization](/content/docs/api/fhir/resources/organization/index.html) >\[\] | Who and/or what authored the composition<br>Details<br>Identifies who is responsible for the information in the composition, not necessarily who typed it in. |
| title | ✓ | string | Human Readable name/title<br>Details<br>Official human-readable label for the composition.<br>For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period. |
| confidentiality |  | code | As defined by affinity domain<br>Details<br>The code specifying the level of confidentiality of the Composition.<br>The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not. |
| attester |  | CompositionAttester\[\] | Attests to accuracy of composition<br>Details<br>A participant who has attested to the accuracy of the composition/document.<br>Only list each attester once. |
| id |  | string | Unique id for inter-element referencing<br>Details<br>Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| extension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Additional content defined by implementations<br>Details<br>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.<br>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. |
| modifierExtension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Extensions that cannot be ignored even if unrecognized<br>Details<br>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.<br>Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).<br>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. |
| mode | ✓ | code | personal \| professional \| legal \| official<br>Details<br>The type of attestation the authenticator offers. |
| time |  | dateTime | When the composition was attested<br>Details<br>When the composition was attested by the party. |
| party |  | Reference< [Patient](/content/docs/api/fhir/resources/patient/index.html)<br> \| [RelatedPerson](/content/docs/api/fhir/resources/relatedperson/index.html)<br> \| [Practitioner](/content/docs/api/fhir/resources/practitioner/index.html)<br> \| [PractitionerRole](/content/docs/api/fhir/resources/practitionerrole/index.html)<br> \| [Organization](/content/docs/api/fhir/resources/organization/index.html) > | Who attested the composition<br>Details<br>Who attested the composition in the specified way. |
| custodian |  | Reference< [Organization](/content/docs/api/fhir/resources/organization/index.html) > | Organization which maintains the composition<br>Details<br>Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.<br>This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged. |
| relatesTo |  | CompositionRelatesTo\[\] | Relationships to other compositions/documents<br>Details<br>Relationships that this composition has with other compositions or documents that already exist.<br>A document is a version specific composition. |
| id |  | string | Unique id for inter-element referencing<br>Details<br>Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| extension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Additional content defined by implementations<br>Details<br>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.<br>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. |
| modifierExtension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Extensions that cannot be ignored even if unrecognized<br>Details<br>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.<br>Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).<br>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. |
| code | ✓ | code | replaces \| transforms \| signs \| appends<br>Details<br>The type of relationship that this composition has with anther composition or document.<br>If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. |
| target\[x\] | ✓ | [Identifier](/content/docs/api/fhir/datatypes/identifier/index.html), Reference< [Composition](/content/docs/api/fhir/resources/composition/index.html) > | Target of the relationship<br>Details<br>The target composition/document of this relationship. |
| event |  | CompositionEvent\[\] | The clinical service(s) being documented<br>Details<br>The clinical service, such as a colonoscopy or an appendectomy, being documented.<br>The event needs to be consistent with the type element, though can provide further information if desired. |
| id |  | string | Unique id for inter-element referencing<br>Details<br>Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| extension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Additional content defined by implementations<br>Details<br>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.<br>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. |
| modifierExtension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Extensions that cannot be ignored even if unrecognized<br>Details<br>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.<br>Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).<br>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. |
| code |  | [CodeableConcept](/content/docs/api/fhir/datatypes/codeableconcept/index.html)\[\] | Code(s) that apply to the event being documented<br>Details<br>This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.<br>An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries. |
| period |  | [Period](/content/docs/api/fhir/datatypes/period/index.html) | The period covered by the documentation<br>Details<br>The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time. |
| detail |  | Reference<Resource>\[\] | The event(s) being documented<br>Details<br>The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy. |
| section |  | CompositionSection\[\] | Composition is broken into sections<br>Details<br>The root of the sections that make up the composition. |
| id |  | string | Unique id for inter-element referencing<br>Details<br>Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| extension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Additional content defined by implementations<br>Details<br>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.<br>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. |
| modifierExtension |  | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)\[\] | Extensions that cannot be ignored even if unrecognized<br>Details<br>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.<br>Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).<br>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.