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ExampleScenario

Example of workflow instance.

Elements

NameRequiredTypeDescription
urluri

Canonical identifier for this example scenario, represented as a URI (globally unique)

Details

An absolute URI that is used to identify this example scenario when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this example scenario is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the example scenario is stored on different servers.

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found.

identifierIdentifier[]

Additional identifier for the example scenario

Details

A formal identifier that is used to identify this example scenario when it is represented in other formats, or referenced in a specification, model, design or an instance.

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this example scenario outside of FHIR, where it is not possible to use the logical URI.

versionstring

Business version of the example scenario

Details

The identifier that is used to identify this version of the example scenario when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the example scenario author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

There may be different example scenario instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the example scenario with the format [url]|[version].

namestring

Name for this example scenario (computer friendly)

Details

A natural language name identifying the example scenario. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

statuscode

draft | active | retired | unknown

Details

The status of this example scenario. Enables tracking the life-cycle of the content.

Allows filtering of example scenarios that are appropriate for use versus not.

experimentalboolean

For testing purposes, not real usage

Details

A Boolean value to indicate that this example scenario is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Allows filtering of example scenarios that are appropriate for use versus not.

datedateTime

Date last changed

Details

The date (and optionally time) when the example scenario was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the example scenario changes. (e.g. the 'content logical definition').

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the example scenario. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

publisherstring

Name of the publisher (organization or individual)

Details

The name of the organization or individual that published the example scenario.

Usually an organization but may be an individual. The publisher (or steward) of the example scenario is the organization or individual primarily responsible for the maintenance and upkeep of the example scenario. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the example scenario. This item SHOULD be populated unless the information is available from context.

contactContactDetail[]

Contact details for the publisher

Details

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

useContextUsageContext[]

The context that the content is intended to support

Details

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate example scenario instances.

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

jurisdictionCodeableConcept[]

Intended jurisdiction for example scenario (if applicable)

Details

A legal or geographic region in which the example scenario is intended to be used.

It may be possible for the example scenario to be used in jurisdictions other than those for which it was originally designed or intended.

copyrightmarkdown

Use and/or publishing restrictions

Details

A copyright statement relating to the example scenario and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the example scenario.

nullFrequently, the copyright differs between the value set and the codes that are included. The copyright statement should clearly differentiate between these when required.

purposemarkdown

The purpose of the example, e.g. to illustrate a scenario

Details

What the example scenario resource is created for. This should not be used to show the business purpose of the scenario itself, but the purpose of documenting a scenario.

This element does not describe the usage of the example scenario. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this example scenario.

actorExampleScenarioActor[]

Actor participating in the resource

Details

Actor participating in the resource.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

actorIdstring

ID or acronym of the actor

Details

ID or acronym of actor.

should this be called ID or acronym?

typecode

person | entity

Details

The type of actor - person or system.

namestring

The name of the actor as shown in the page

Details

The name of the actor as shown in the page.

Cardinality: is name and description 1..1?

descriptionmarkdown

The description of the actor

Details

The description of the actor.

Cardinality: is name and description 1..1?

instanceExampleScenarioInstance[]

Each resource and each version that is present in the workflow

Details

Each resource and each version that is present in the workflow.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

resourceIdstring

The id of the resource for referencing

Details

The id of the resource for referencing.

resourceTypecode

The type of the resource

Details

The type of the resource.

namestring

A short name for the resource instance

Details

A short name for the resource instance.

descriptionmarkdown

Human-friendly description of the resource instance

Details

Human-friendly description of the resource instance.

versionExampleScenarioInstanceVersion[]

A specific version of the resource

Details

A specific version of the resource.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

versionIdstring

The identifier of a specific version of a resource

Details

The identifier of a specific version of a resource.

descriptionmarkdown

The description of the resource version

Details

The description of the resource version.

containedInstanceExampleScenarioInstanceContainedInstance[]

Resources contained in the instance

Details

Resources contained in the instance (e.g. the observations contained in a bundle).

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

resourceIdstring

Each resource contained in the instance

Details

Each resource contained in the instance.

versionIdstring

A specific version of a resource contained in the instance

Details

A specific version of a resource contained in the instance.

processExampleScenarioProcess[]

Each major process - a group of operations

Details

Each major process - a group of operations.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

titlestring

The diagram title of the group of operations

Details

The diagram title of the group of operations.

descriptionmarkdown

A longer description of the group of operations

Details

A longer description of the group of operations.

preConditionsmarkdown

Description of initial status before the process starts

Details

Description of initial status before the process starts.

postConditionsmarkdown

Description of final status after the process ends

Details

Description of final status after the process ends.

stepExampleScenarioProcessStep[]

Each step of the process

Details

Each step of the process.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

process[]

Nested process

Details

Nested process.

pauseboolean

If there is a pause in the flow

Details

If there is a pause in the flow.

operationExampleScenarioProcessStepOperation

Each interaction or action

Details

Each interaction or action.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

numberstring

The sequential number of the interaction

Details

The sequential number of the interaction, e.g. 1.2.5.

typestring

The type of operation - CRUD

Details

The type of operation - CRUD.

namestring

The human-friendly name of the interaction

Details

The human-friendly name of the interaction.

initiatorstring

Who starts the transaction

Details

Who starts the transaction.

receiverstring

Who receives the transaction

Details

Who receives the transaction.

descriptionmarkdown

A comment to be inserted in the diagram

Details

A comment to be inserted in the diagram.

initiatorActiveboolean

Whether the initiator is deactivated right after the transaction

Details

Whether the initiator is deactivated right after the transaction.

receiverActiveboolean

Whether the receiver is deactivated right after the transaction

Details

Whether the receiver is deactivated right after the transaction.

request

Each resource instance used by the initiator

Details

Each resource instance used by the initiator.

response

Each resource instance used by the responder

Details

Each resource instance used by the responder.

alternativeExampleScenarioProcessStepAlternative[]

Alternate non-typical step action

Details

Indicates an alternative step that can be taken instead of the operations on the base step in exceptional/atypical circumstances.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

titlestring

Label for alternative

Details

The label to display for the alternative that gives a sense of the circumstance in which the alternative should be invoked.

descriptionmarkdown

A human-readable description of each option

Details

A human-readable description of the alternative explaining when the alternative should occur rather than the base step.

step[]

What happens in each alternative option

Details

What happens in each alternative option.

workflowcanonical[]

Another nested workflow

Details

Another nested workflow.

Search Parameters

NameTypeDescriptionExpression
contexttokenA use context assigned to the example scenarioExampleScenario.useContext.value as CodeableConcept
context-quantityquantityA quantity- or range-valued use context assigned to the example scenarioExampleScenario.useContext.value as Quantity | ExampleScenario.useContext.value as Range
context-typetokenA type of use context assigned to the example scenarioExampleScenario.useContext.code
datedateThe example scenario publication dateExampleScenario.date
identifiertokenExternal identifier for the example scenarioExampleScenario.identifier
jurisdictiontokenIntended jurisdiction for the example scenarioExampleScenario.jurisdiction
namestringComputationally friendly name of the example scenarioExampleScenario.name
publisherstringName of the publisher of the example scenarioExampleScenario.publisher
statustokenThe current status of the example scenarioExampleScenario.status
urluriThe uri that identifies the example scenarioExampleScenario.url
versiontokenThe business version of the example scenarioExampleScenario.version
context-type-quantitycompositeA use context type and quantity- or range-based value assigned to the example scenarioExampleScenario.useContext
context-type-valuecompositeA use context type and value assigned to the example scenarioExampleScenario.useContext

Inherited Elements

NameRequiredTypeDescription
idstring

Logical id of this artifact

Details

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

metaMeta

Metadata about the resource

Details

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

implicitRulesuri

A set of rules under which this content was created

Details

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

languagecode

Language of the resource content

Details

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

textNarrative

Text summary of the resource, for human interpretation

Details

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

containedResource[]

Contained, inline Resources

Details

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the resource. 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.

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.

modifierExtensionExtension[]

Extensions that cannot be ignored

Details

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.