ClinicalDocument/relatedDocument/ParentDocument/id/@root SHALL be the ClinicalDocument/Id/@root for the document it relates to.

ClinicalDocument/relatedDocument/ParentDocument/id/@extension SHALL be the ClinicalDocument/Id/@extension for the document it relates to

ClinicalDocument/relatedDocument/ParentDocument/id/@assigningAuthorityName SHALL be the ClinicalDocument/Id/@assigningAuthorityName for the document it relates to.

parentDocumentMAY contain the text element with the text.mediaType attribute set to indicate the MIME type of the related document.

The related document SHALL NOT be embedded inparentDocument/text element.

When sending a relatedDocument, the ClinicalDocument/relatedDocument.typeCode  SHALL be present, set at the value of “RPLC” for the original version of the document, and in the instance of a replacement document the versionNumberif present, SHALL be an increment of 1 from the document version it replaces. 

Replacement documents are meant to completely replace the previous version of a document, and as such SHALL NOT be handled as addendums in receiving systems.

Replacement documents SHALL represent a transitive relationship, where document A.1 can be replaced by A.2, A.2 can be replaced by A.3, and so on.  Multiple documents SHALL NOT replace the same document; i.e. A.1 being replaced by A.2 and also by A.3.

Receiving systems MAY retain parent documents that are considered superseded for historical and auditing purposes.  If parent documents are maintained, the receiving system SHALL very clearly identify the parent document as superseded by a more current version of the document.