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In the FHIR specification, the narrative has two child elements, status and div, with both having a cardinality of 1..1. My understanding of this is that narratives must have child elements status and div.

However, I have seen resources in which the narratives have no such child elements, like the discharge summary-example here. Such a resource will also be validated as valid by the FHIR validator. Am I missing or misunderstanding something here?

Enigma
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  • I see all of the narrative elements containing both "status" and "div" in the example you pointed to. Did you mean to point to a different example? (There's no narrative on the Bundle - Bundles aren't allowed to have the element.) – Lloyd McKenzie May 21 '16 at 20:32
  • Oh I see. What confused me is that I have seen there are some `text` elements that only have a value attribute without child elements `status` and `div` e.g. `` in the bundle resource in the above example. But I see now that those `text` elements are not the `text` elements of the narratives but CodeableConcept.text which is just a string. – Enigma May 21 '16 at 20:46

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The text element itself is optional. So some resources don't have text, and if they don't have text, they don't have status or div. If text is present, both status and div must be present.

Grahame Grieve
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  • I know. See my comment to Lloyd McKenzie. I was confused by some `text` elements in the bundle resource example (discharge summary) that contained neither `div` nor `status`. It tuned out that they were not the `text` of narrative but CodeableConcept.text which was just a string. So, for this types of texts, it is valid to have just `` without having child elements `div` or `status`. – Enigma May 21 '16 at 21:36