{
  "types": [
    "Linkage"
  ],
  "Linkage": {
    "elements": {
      "Linkage.item.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/linkage-type|4.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/linkage-type|5.0.0",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  }
}