Summary
Diagnostics
Care Provision
Request & Response
Medications
Workflow
Entities
Management
Individuals
General
Billing
Support
Payment
Security
Other
Conformance
Documents
Terminology
Definitional Artifacts
Medication Definition
Evidence-Based Medicine
Quality Reporting & Testing
Public Health & Research
Complex
Primitive
ActivityDefinition
CapabilityStatement
ChargeItemDefinition
Claim
CodeSystem
Composition
ConceptMap
CoverageEligibilityRequest
Encounter
Group
Library
List
Measure
MedicinalProductDefinition
MessageHeader
NamingSystem
Observation
Patient
PlanDefinition
Resource
StructureDefinition
StructureMap
ValueSet
default
A container for a collection of resources.
Bundle
Path
Bundle
Id
Bundle
Cardinality
0 - *
Definition
A container for a collection of resources.
Comment
Constraint
bdl-1 [error]
total only when a search or history
bdl-2 [error]
entry.search only when a search
bdl-3 [error]
entry.request mandatory for batch/transaction/history, otherwise prohibited
bdl-4 [error]
entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
bdl-7 [error]
FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
bdl-9 [error]
A document must have an identifier with a system and a value
bdl-10 [error]
A document must have a date
bdl-11 [error]
A document must have a Composition as the first resource
bdl-12 [error]
A message must have a MessageHeader as the first resource
Path
Bundle.identifier
Id
Bundle.identifier
Type
Cardinality
0 - 1
Definition
A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Comment
Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.type.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.period.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Bundle.identifier.Identifier.period.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Bundle.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-1
Path
Bundle.identifier.Identifier.assigner.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.identifier.Identifier.assigner.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
type
document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Path
Bundle.type
Id
Bundle.type
Type
Cardinality
1 - 1
Definition
Indicates the purpose of this bundle - how it is intended to be used.
Comment
It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.
Binding
Strength
required
Description
Indicates the purpose of a bundle - how it is intended to be used.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.timestamp
Id
Bundle.timestamp
Type
Cardinality
0 - 1
Definition
The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Comment
For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.
Usage:
* document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
* message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
* history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
* searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
* transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning
The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.total
Id
Bundle.total
Type
Cardinality
0 - 1
Definition
If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle.
Comment
Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
bdl-1
Path
Bundle.link
Id
Bundle.link
Type
Cardinality
0 - *
Definition
A series of links that provide context to this bundle.
Comment
Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. [HATEOAS](http://en.wikipedia.org/wiki/HATEOAS)).
Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was [read](http.html#read) directly.
This specification defines some specific uses of Bundle.link for [searching](search.html#conformance) and [paging](http.html#paging), but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children unless an empty Parameters resource
relation
See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
Path
Bundle.link.relation
Id
Bundle.link.relation
Type
Cardinality
1 - 1
Definition
A name which details the functional use for this link - see [http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1](http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.link.url
Id
Bundle.link.url
Type
Cardinality
1 - 1
Definition
The reference details for the link.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry
Id
Bundle.entry
Type
Cardinality
0 - *
Definition
An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Comment
Constraint
bdl-5 [error]
must be a resource unless there's a request or response
bdl-8 [error]
fullUrl cannot be a version specific reference
ele-1 [error]
All FHIR elements must have a @value or children unless an empty Parameters resource
Path
Bundle.entry.link
Id
Bundle.entry.link
Type
Cardinality
0 - *
Definition
A series of links that provide context to this entry.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.fullUrl
Id
Bundle.entry.fullUrl
Type
Cardinality
0 - 1
Definition
The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:
* fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
* Results from operations might involve resources that are not identified.
Comment
fullUrl might not be [unique in the context of a resource](bundle.html#bundle-unique). Note that since [FHIR resources do not need to be served through the FHIR API](references.html), the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the [regex](references.html#regex), then the 'id' portion of the fullUrl SHALL end with the Resource.id.
Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.resource
Id
Bundle.entry.resource
Type
Cardinality
0 - 1
Definition
The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Comment
Path
Bundle.entry.search
Id
Bundle.entry.search
Type
Cardinality
0 - 1
Definition
Information about the search process that lead to the creation of this entry.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children unless an empty Parameters resource
Condition
bdl-2
Path
Bundle.entry.search.mode
Id
Bundle.entry.search.mode
Type
Cardinality
0 - 1
Definition
Why this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
Comment
There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence.
Binding
Strength
required
Description
Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.search.score
Id
Bundle.entry.search.score
Type
Cardinality
0 - 1
Definition
When searching, the server's search ranking score for the entry.
Comment
Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order.
See [Patient Match](patient-operation-match.html) for the EMPI search which relates to this element.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request
Id
Bundle.entry.request
Type
Cardinality
0 - 1
Definition
Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children unless an empty Parameters resource
Condition
bdl-3
Path
Bundle.entry.request.method
Id
Bundle.entry.request.method
Type
Cardinality
1 - 1
Definition
In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred.
Comment
Binding
Strength
required
Description
HTTP verbs (in the HTTP command line). See [HTTP rfc](https://tools.ietf.org/html/rfc7231) for details.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request.url
Id
Bundle.entry.request.url
Type
Cardinality
1 - 1
Definition
The URL for this entry, relative to the root (the address to which the request is posted).
Comment
E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]".
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request.ifNoneMatch
Id
Bundle.entry.request.ifNoneMatch
Type
Cardinality
0 - 1
Definition
If the ETag values match, return a 304 Not Modified status. See the API documentation for ["Conditional Read"](http.html#cread).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request.ifModifiedSince
Id
Bundle.entry.request.ifModifiedSince
Type
Cardinality
0 - 1
Definition
Only perform the operation if the last updated date matches. See the API documentation for ["Conditional Read"](http.html#cread).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request.ifMatch
Id
Bundle.entry.request.ifMatch
Type
Cardinality
0 - 1
Definition
Only perform the operation if the Etag value matches. For more information, see the API section ["Managing Resource Contention"](http.html#concurrency).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.request.ifNoneExist
Id
Bundle.entry.request.ifNoneExist
Type
Cardinality
0 - 1
Definition
Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for ["Conditional Create"](http.html#ccreate). This is just the query portion of the URL - what follows the "?" (not including the "?").
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.response
Id
Bundle.entry.response
Type
Cardinality
0 - 1
Definition
Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children unless an empty Parameters resource
Condition
bdl-4
Path
Bundle.entry.response.status
Id
Bundle.entry.response.status
Type
Cardinality
1 - 1
Definition
The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.response.location
Id
Bundle.entry.response.location
Type
Cardinality
0 - 1
Definition
The location header created by processing this operation, populated if the operation returns a location.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.response.etag
Id
Bundle.entry.response.etag
Type
Cardinality
0 - 1
Definition
The Etag for the resource, if the operation for the entry produced a versioned resource (see [Resource Metadata and Versioning](http.html#versioning) and [Managing Resource Contention](http.html#concurrency)).
Comment
Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.response.lastModified
Id
Bundle.entry.response.lastModified
Type
Cardinality
0 - 1
Definition
The date/time that the resource was modified on the server.
Comment
This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.entry.response.outcome
Id
Bundle.entry.response.outcome
Type
Cardinality
0 - 1
Definition
An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Comment
For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned.
This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error.
Path
Bundle.signature
Id
Bundle.signature
Type
Cardinality
0 - 1
Definition
Digital Signature - base64 encoded. XML-DSig or a JWT.
Comment
The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.
Requirements
A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type
Id
Signature.type
Type
Cardinality
1 - *
Definition
An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.
Comment
Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.type.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.when
Id
Signature.when
Type
Cardinality
1 - 1
Definition
When the digital signature was signed.
Comment
This should agree with the information in the signature.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who
Id
Signature.who
Type
Cardinality
1 - 1
Definition
A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).
Comment
This should agree with the information in the signature.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-1
Path
Bundle.signature.Signature.who.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.who.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf
Id
Signature.onBehalfOf
Type
Cardinality
0 - 1
Definition
A reference to an application-usable description of the identity that is represented by the signature.
Comment
The party that can't sign. For example a child.
Requirements
used when the signature is on behalf of a non-signer.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-1
Path
Bundle.signature.Signature.onBehalfOf.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.onBehalfOf.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.targetFormat
Id
Signature.targetFormat
Type
Cardinality
0 - 1
Definition
A mime type that indicates the technical format of the target resources signed by the signature.
Comment
"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.
Binding
Strength
required
Description
BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.sigFormat
Id
Signature.sigFormat
Type
Cardinality
0 - 1
Definition
A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.
Comment
Binding
Strength
required
Description
BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Bundle.signature.Signature.data
Id
Signature.data
Type
Cardinality
0 - 1
Definition
The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.
Comment
Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children