Bundles

Air filter replaced

AirFilterReplacedBundle (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Procedure, Device, Practitioner	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Procedure, Device, Practitioner Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
identifier				There are no (further) constraints on this element Element id Bundle.identifier

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Procedure, Device, Practitioner
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
Bundle.identifier

<id value="AirFilterReplacedBundle" />
<url value="http://example.org/fhir/StructureDefinition/AirFilterReplacedBundle" />
<name value="AirFilterReplacedBundle" />
<status value="draft" />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<differential>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<patternString value="Air Filter Replaced" />
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
<type>
<code value="Device" />
</type>
<type>
<code value="Practitioner" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<patternCode value="completed" />
</element>
<element id="Bundle.entry.resource.Device.name.value">
<path value="Bundle.entry.resource.Device.name.value" />
<min value="1" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "AirFilterReplacedBundle",
"url": "http://example.org/fhir/StructureDefinition/AirFilterReplacedBundle",
"name": "AirFilterReplacedBundle",
"status": "draft",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"differential": {
"element": [
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection"
},
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"patternString": "Air Filter Replaced"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
},
{
"code": "Device"
},
{
"code": "Practitioner"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"patternCode": "completed"
},
{
"id": "Bundle.entry.resource.Device.name.value",
"path": "Bundle.entry.resource.Device.name.value",
"min": 1
}
]
}

}

Wild Cycle

WildCycleBundle (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Procedure, Observation, Practitioner, Device	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Procedure, Observation, Practitioner, Device Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Observation				There are no (further) constraints on this element Element id Bundle.entry.resource.Observation
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
identifier				There are no (further) constraints on this element Element id Bundle.identifier

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Procedure, Observation, Practitioner, Device
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.Procedure
Bundle.entry.resource.Observation
Bundle.entry.resource.Device
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
Bundle.identifier

<id value="WildCycleBundle" />
<url value="http://example.org/fhir/StructureDefinition/WildCycleBundle" />
<version value="1.0.0" />
<name value="WildCycleBundle" />
<status value="draft" />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<patternString value="Wild Cycle" />
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
<type>
<code value="Observation" />
</type>
<type>
<code value="Practitioner" />
</type>
<type>
<code value="Device" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<patternCode value="completed" />
</element>
<element id="Bundle.entry.resource.Observation.status">
<path value="Bundle.entry.resource.Observation.status" />
<min value="1" />
<patternCode value="final" />
</element>
<element id="Bundle.entry.resource.Observation.value[x]">
<path value="Bundle.entry.resource.Observation.value[x]" />
<min value="1" />
<type>
<code value="integer" />
</type>
</element>
<element id="Bundle.entry.resource.Device.name.value">
<path value="Bundle.entry.resource.Device.name.value" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.serialNumber">
<path value="Bundle.entry.resource.Device.serialNumber" />
<min value="1" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "WildCycleBundle",
"url": "http://example.org/fhir/StructureDefinition/WildCycleBundle",
"version": "1.0.0",
"name": "WildCycleBundle",
"status": "draft",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection"
},
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"patternString": "Wild Cycle"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
},
{
"code": "Observation"
},
{
"code": "Practitioner"
},
{
"code": "Device"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"patternCode": "completed"
},
{
"id": "Bundle.entry.resource.Observation.status",
"path": "Bundle.entry.resource.Observation.status",
"min": 1,
"patternCode": "final"
},
{
"id": "Bundle.entry.resource.Observation.value[x]",
"path": "Bundle.entry.resource.Observation.value[x]",
"min": 1,
"type": [
{
"code": "integer"
}
]
},
{
"id": "Bundle.entry.resource.Device.name.value",
"path": "Bundle.entry.resource.Device.name.value",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.serialNumber",
"path": "Bundle.entry.resource.Device.serialNumber",
"min": 1
}
]
}

}

Test Strip Bottle Enrolled

TestStripBottleEnrolled (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Procedure, Device, Practitioner, Observation, Substance, Organization	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Procedure, Device, Practitioner, Observation, Substance, Organization Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
Observation				There are no (further) constraints on this element Element id Bundle.entry.resource.Observation
Substance				There are no (further) constraints on this element Element id Bundle.entry.resource.Substance
Organization				There are no (further) constraints on this element Element id Bundle.entry.resource.Organization
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
identifier				There are no (further) constraints on this element Element id Bundle.identifier

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Procedure, Device, Practitioner, Observation, Substance, Organization
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.resource.Observation
Bundle.entry.resource.Substance
Bundle.entry.resource.Organization
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
Bundle.identifier

<id value="TestStripBottleEnrolled" />
<url value="http://example.org/fhir/StructureDefinition/TestStripBottleEnrolled" />
<version value="1.0.0" />
<name value="TestStripBottleEnrolled" />
<status value="draft" />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<patternString value="Test Strip Bottle Enrolled" />
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
<type>
<code value="Device" />
</type>
<type>
<code value="Practitioner" />
</type>
<type>
<code value="Observation" />
</type>
<type>
<code value="Substance" />
</type>
<type>
<code value="Organization" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<patternCode value="completed" />
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.name.value">
<path value="Bundle.entry.resource.Device.name.value" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Observation.status">
<path value="Bundle.entry.resource.Observation.status" />
<min value="1" />
<patternCode value="final" />
</element>
<element id="Bundle.entry.resource.Observation.valueQuantity.value">
<path value="Bundle.entry.resource.Observation.valueQuantity.value" />
<min value="1" />
<type>
<code value="decimal" />
</type>
</element>
<element id="Bundle.entry.resource.Substance.code.concept.text">
<path value="Bundle.entry.resource.Substance.code.concept.text" />
<min value="1" />
<patternString value="Test Strip Bottle" />
</element>
<element id="Bundle.entry.resource.Substance.instance">
<path value="Bundle.entry.resource.Substance.instance" />
<min value="1" />
<patternBoolean value="true" />
</element>
<element id="Bundle.entry.resource.Substance.expiry">
<path value="Bundle.entry.resource.Substance.expiry" />
<min value="1" />
<type>
<code value="dateTime" />
</type>
</element>
<element id="Bundle.entry.resource.Organization.name">
<path value="Bundle.entry.resource.Organization.name" />
<min value="1" />
<patternString value="UltrOx" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "TestStripBottleEnrolled",
"url": "http://example.org/fhir/StructureDefinition/TestStripBottleEnrolled",
"version": "1.0.0",
"name": "TestStripBottleEnrolled",
"status": "draft",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection"
},
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"patternString": "Test Strip Bottle Enrolled"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
},
{
"code": "Device"
},
{
"code": "Practitioner"
},
{
"code": "Observation"
},
{
"code": "Substance"
},
{
"code": "Organization"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"patternCode": "completed"
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.name.value",
"path": "Bundle.entry.resource.Device.name.value",
"min": 1
},
{
"id": "Bundle.entry.resource.Observation.status",
"path": "Bundle.entry.resource.Observation.status",
"min": 1,
"patternCode": "final"
},
{
"id": "Bundle.entry.resource.Observation.valueQuantity.value",
"path": "Bundle.entry.resource.Observation.valueQuantity.value",
"min": 1,
"type": [
{
"code": "decimal"
}
]
},
{
"id": "Bundle.entry.resource.Substance.code.concept.text",
"path": "Bundle.entry.resource.Substance.code.concept.text",
"min": 1,
"patternString": "Test Strip Bottle"
},
{
"id": "Bundle.entry.resource.Substance.instance",
"path": "Bundle.entry.resource.Substance.instance",
"min": 1,
"patternBoolean": true
},
{
"id": "Bundle.entry.resource.Substance.expiry",
"path": "Bundle.entry.resource.Substance.expiry",
"min": 1,
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "Bundle.entry.resource.Organization.name",
"path": "Bundle.entry.resource.Organization.name",
"min": 1,
"patternString": "UltrOx"
}
]
}

}

Water Filter Replaced

WaterFilterReplaced (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Procedure, Device, Practitioner	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Procedure, Device, Practitioner Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
Practitioner				There are no (further) constraints on this element Element id Bundle.entry.resource.Practitioner
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
identifier				There are no (further) constraints on this element Element id Bundle.identifier

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Procedure, Device, Practitioner
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.resource.Practitioner
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
Bundle.identifier

<id value="WaterFilterReplaced" />
<url value="http://example.org/fhir/StructureDefinition/WaterFilterReplaced" />
<version value="1.0.0" />
<name value="WaterFilterReplaced" />
<status value="draft" />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<patternString value="Water Filter Replaced" />
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
<type>
<code value="Device" />
</type>
<type>
<code value="Practitioner" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<patternCode value="completed" />
</element>
<element id="Bundle.entry.resource.Procedure.occurrenceDateTime">
<path value="Bundle.entry.resource.Procedure.occurrenceDateTime" />
<min value="1" />
<type>
<code value="dateTime" />
</type>
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.name.value">
<path value="Bundle.entry.resource.Device.name.value" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.expirationDate">
<path value="Bundle.entry.resource.Device.expirationDate" />
<min value="0" />
<type>
<code value="date" />
</type>
</element>
<element id="Bundle.entry.resource.Practitioner.identifier.value">
<path value="Bundle.entry.resource.Practitioner.identifier.value" />
<min value="1" />
<patternString value="Operator_ID" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "WaterFilterReplaced",
"url": "http://example.org/fhir/StructureDefinition/WaterFilterReplaced",
"version": "1.0.0",
"name": "WaterFilterReplaced",
"status": "draft",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection"
},
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"patternString": "Water Filter Replaced"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
},
{
"code": "Device"
},
{
"code": "Practitioner"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"patternCode": "completed"
},
{
"id": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"path": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"min": 1,
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.name.value",
"path": "Bundle.entry.resource.Device.name.value",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.expirationDate",
"path": "Bundle.entry.resource.Device.expirationDate",
"min": 0,
"type": [
{
"code": "date"
}
]
},
{
"id": "Bundle.entry.resource.Practitioner.identifier.value",
"path": "Bundle.entry.resource.Practitioner.identifier.value",
"min": 1,
"patternString": "Operator_ID"
}
]
}

}

HLD Replaced

HLDReplaced (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Procedure, Device, Practitioner, Substance, Organization	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Procedure, Device, Practitioner, Substance, Organization Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
Substance				There are no (further) constraints on this element Element id Bundle.entry.resource.Substance
Organization				There are no (further) constraints on this element Element id Bundle.entry.resource.Organization
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
identifier				There are no (further) constraints on this element Element id Bundle.identifier

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Procedure, Device, Practitioner, Substance, Organization
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.resource.Substance
Bundle.entry.resource.Organization
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17
Bundle.identifier

<id value="HLDReplaced" />
<url value="http://example.org/fhir/StructureDefinition/HLDReplaced" />
<version value="1.0.0" />
<name value="HLDReplaced" />
<title value="HLD Replaced" />
<status value="draft" />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<patternString value="HLD Replaced" />
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
<type>
<code value="Device" />
</type>
<type>
<code value="Practitioner" />
</type>
<type>
<code value="Substance" />
</type>
<type>
<code value="Organization" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<patternCode value="completed" />
</element>
<element id="Bundle.entry.resource.Procedure.occurrenceDateTime">
<path value="Bundle.entry.resource.Procedure.occurrenceDateTime" />
<min value="1" />
<type>
<code value="dateTime" />
</type>
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Device.name.value">
<path value="Bundle.entry.resource.Device.name.value" />
<min value="1" />
</element>
<element id="Bundle.entry.resource.Substance.code.concept.text">
<path value="Bundle.entry.resource.Substance.code.concept.text" />
<min value="1" />
<patternString value="HLD" />
</element>
<element id="Bundle.entry.resource.Substance.expiry">
<path value="Bundle.entry.resource.Substance.expiry" />
<min value="1" />
<type>
<code value="date" />
</type>
</element>
<element id="Bundle.entry.resource.Substance.extension.url">
<path value="Bundle.entry.resource.Substance.extension.url" />
<min value="1" />
<patternString value="https://fhir.simplifier.net/sample-test/StructureDefinition/HLDInformationExtension" />
</element>
<element id="Bundle.entry.resource.Organization.name">
<path value="Bundle.entry.resource.Organization.name" />
<min value="1" />
<patternString value="UltrOx" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "HLDReplaced",
"url": "http://example.org/fhir/StructureDefinition/HLDReplaced",
"version": "1.0.0",
"name": "HLDReplaced",
"title": "HLD Replaced",
"status": "draft",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection"
},
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"patternString": "HLD Replaced"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
},
{
"code": "Device"
},
{
"code": "Practitioner"
},
{
"code": "Substance"
},
{
"code": "Organization"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"patternCode": "completed"
},
{
"id": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"path": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"min": 1,
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1
},
{
"id": "Bundle.entry.resource.Device.name.value",
"path": "Bundle.entry.resource.Device.name.value",
"min": 1
},
{
"id": "Bundle.entry.resource.Substance.code.concept.text",
"path": "Bundle.entry.resource.Substance.code.concept.text",
"min": 1,
"patternString": "HLD"
},
{
"id": "Bundle.entry.resource.Substance.expiry",
"path": "Bundle.entry.resource.Substance.expiry",
"min": 1,
"type": [
{
"code": "date"
}
]
},
{
"id": "Bundle.entry.resource.Substance.extension.url",
"path": "Bundle.entry.resource.Substance.extension.url",
"min": 1,
"patternString": "https://fhir.simplifier.net/sample-test/StructureDefinition/HLDInformationExtension"
},
{
"id": "Bundle.entry.resource.Organization.name",
"path": "Bundle.entry.resource.Organization.name",
"min": 1,
"patternString": "UltrOx"
}
]
}

}

Disinfection Cycle

DisinfectionCycle (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	1..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	1..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	1..1	DeviceDefinition	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type DeviceDefinition Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.entry.resource.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.resource.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text	C	0..1	Narrative	There are no (further) constraints on this element Element id Bundle.entry.resource.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments Contained resources do not have a 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. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: dom-6 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained	C	0..*	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. Comments 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. Data type Resource Conditions The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5 Mappings rim: N/A
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Bundle.entry.resource.identifier Short description External Identifiers for this procedure Definition Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server. Requirements Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier v2: PR1-19 rim: .id
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)	There are no (further) constraints on this element Element id Bundle.entry.resource.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure. Data type canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id Bundle.entry.resource.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ	0..*	Reference(CarePlan \| ServiceRequest)	There are no (further) constraints on this element Element id Bundle.entry.resource.basedOn Short description A request for this procedure Alternate names fulfills Definition A reference to a resource that contains details of the request for this procedure. Data type Reference(CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
partOf	Σ	0..*	Reference(Procedure \| Observation \| MedicationAdministration)	There are no (further) constraints on this element Element id Bundle.entry.resource.partOf Short description Part of referenced event Alternate names container Definition A larger event of which this particular procedure is a component or step. Comments The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration). Data type Reference(Procedure \| Observation \| MedicationAdministration) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf v2: PR1-25 rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.status Short description preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Definition A code specifying the state of the procedure. Generally, this will be the in-progress or completed state. Comments The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A code specifying the state of the procedure. EventStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: statusCode
statusReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.statusReason Short description Reason for current status Alternate names Suspended Reason, Cancelled Reason Definition Captures the reason for the current state of the procedure. Comments This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here. Data type CodeableConcept Binding A code that identifies the reason a procedure was not performed. ProcedureNotPerformedReasonSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason rim: .reason.Observation.value
category	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.category Short description Classification of the procedure Definition A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure"). Data type CodeableConcept Binding A code that classifies a procedure for searching, sorting and display purposes. ProcedureCategoryCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class v2: PR1-6 rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
code	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.code Short description Identification of the procedure Alternate names type Definition The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy"). Requirements 0..1 to account for primarily narrative only resources. Data type CodeableConcept Binding A code to identify a specific procedure . ProcedureCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] v2: PR1-3 rim: .code
subject	Σ	1..1	Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location)	There are no (further) constraints on this element Element id Bundle.entry.resource.subject Short description Individual or entity the procedure was performed on Alternate names patient Definition On whom or on what the procedure was performed. This is usually an individual human, but can also be performed on animals, groups of humans or animals, organizations or practitioners (for licensing), locations or devices (for safety inspections or regulatory authorizations). If the actual focus of the procedure is different from the subject, the focus element specifies the actual focus of the procedure. Data type Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role
focus	Σ	0..1	Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen)	There are no (further) constraints on this element Element id Bundle.entry.resource.focus Short description Who is the target of the procedure when it is not the subject of record only Definition Who is the target of the procedure when it is not the subject of record only. If focus is not present, then subject is the focus. If focus is present and the subject is one of the targets of the procedure, include subject as a focus as well. If focus is present and the subject is not included in focus, it implies that the procedure was only targeted on the focus. For example, when a caregiver is given education for a patient, the caregiver would be the focus and the procedure record is associated with the subject (e.g. patient). For example, use focus when recording the target of the education, training, or counseling is the parent or relative of a patient. Data type Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.subject[x]
encounter	Σ	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Bundle.entry.resource.encounter Short description The Encounter during which this Procedure was created Definition The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context v2: PV1-19 rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
occurrence[x]	Σ	0..1		There are no (further) constraints on this element Element id Bundle.entry.resource.occurrence[x] Short description When the procedure occurred or is occurring Definition Estimated or actual date, date-time, period, or age when the procedure did occur or is occurring. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured. Comments This indicates when the procedure actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this Procedure is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds. Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: PR1-5 - occurrencePeriod.end can be inferred when both PR1-5 (Procedure Date/Time) and PR1-7 (Procedure Minutes) are populated rim: .effectiveTime
occurrenceDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
occurrencePeriod			Period	There are no (further) constraints on this element Data type Period
occurrenceString			string	There are no (further) constraints on this element Data type string
occurrenceAge			Age	There are no (further) constraints on this element Data type Age
occurrenceRange			Range	There are no (further) constraints on this element Data type Range
occurrenceTiming			Timing	There are no (further) constraints on this element Data type Timing
recorded	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Bundle.entry.resource.recorded Short description When the procedure was first captured in the subject's record Definition The date the occurrence of the procedure was first captured in the record regardless of Procedure.status (potentially after the occurrence of the event). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.recorded w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
recorder	Σ	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Bundle.entry.resource.recorder Short description Who recorded the procedure Definition Individual who recorded the record and takes responsibility for its content. Data type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.author rim: .participation[typeCode=AUT].role
reported[x]	Σ	0..1		There are no (further) constraints on this element Element id Bundle.entry.resource.reported[x] Short description Reported rather than primary record Alternate names informer Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Requirements Reported data may have different rules on editing and may be visually distinguished from primary data. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reported[x] w5: FiveWs.source rim: .participation[typeCode=RPT].role
reportedBoolean			boolean	There are no (further) constraints on this element Data type boolean
reportedReference			Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)	There are no (further) constraints on this element Data type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)
performer	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.resource.performer Short description Who performed the procedure and what they did Definition Indicates who or what performed the procedure and how they were involved. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` prc-1: Procedure.performer.onBehalfOf can only be populated when performer.actor isn't Practitioner or PractitionerRole `onBehalfOf.exists() and actor.resolve().exists() implies actor.resolve().where($this is Practitioner or $this is PractitionerRole).empty()` Mappings workflow: Event.performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. Requirements Allows disambiguation of the types of involvement of different performers. Data type CodeableConcept Binding A code that identifies the role of a performer of the procedure. ProcedurePerformerRoleCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.function v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25 rim: .functionCode
actor	Σ C	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService)	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.actor Short description Who performed the procedure Definition Indicates who or what performed the procedure. Requirements A reference to Device supports use cases, such as pacemakers. Data type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService) Conditions The cardinality or value of this element may be affected by these constraints: prc-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor v2: PR1-8 (Anesthesiologist), PR1-11 (Surgeon), PR1-12 (Procedure Practitioner) --> Procedure.performer.actor where Procedure.performer.function is also populated rim: .role
onBehalfOf	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.onBehalfOf Short description Organization the device or practitioner was acting for Definition The Organization the Patient, RelatedPerson, Device, CareTeam, and HealthcareService was acting on behalf of. Requirements Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action. Comments Organization, Patient, RelatedPerson, Device, CareTeam, and HealthcareService can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: prc-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .scoper
period		0..1	Period	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.period Short description When the performer performed the procedure Definition Time period during which the performer performed the procedure. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	Reference(Location)	There are no (further) constraints on this element Element id Bundle.entry.resource.location Short description Where the procedure happened Definition The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.where[x] v2: PR1-23 rim: .participation[typeCode=LOC].role[classCode=SDLOC]
reason	Σ	0..*	CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id Bundle.entry.resource.reason Short description The justification that the procedure was performed Definition The coded reason or reference why the procedure was performed. This may be a coded entity of some type, be present as text, or be a reference to one of several resources that justify the procedure. Comments Use Procedure.reason.concept when a code sufficiently describes the reason. Use Procedure.reason.reference when referencing a resource, which allows more information to be conveyed, such as onset date. For a single Procedure.reason, if both Procedure.reason.concept and Procedure.reason.reference are present, they are expected to be consistent with each other. Data type CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference) Binding A code that identifies the reason a procedure is required. ProcedureReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reason w5: FiveWs.why[x] v2: PR1-15 rim: .reasonCode
bodySite	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.bodySite Short description Target body sites Definition Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure. Data type CodeableConcept Binding SNOMED CT Body site concepts SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-20 rim: .targetSiteCode
outcome	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.outcome Short description The result of procedure Definition The outcome of the procedure - did it resolve the reasons for the procedure being performed? Comments If outcome contains narrative text only, it can be captured using the CodeableConcept.text. Data type CodeableConcept Binding An outcome of a procedure - whether it was resolved or otherwise. ProcedureOutcomeCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=OUT].target.text
report		0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	There are no (further) constraints on this element Element id Bundle.entry.resource.report Short description Any report resulting from the procedure Definition This could be a histology result, pathology report, surgical report, etc. Comments There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports. Data type Reference(DiagnosticReport \| DocumentReference \| Composition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
complication		0..*	CodeableReference(Condition)	There are no (further) constraints on this element Element id Bundle.entry.resource.complication Short description Complication following the procedure Definition Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues. Comments If complications are only expressed by the narrative text, they can be captured using the CodeableReference.concept.text. Data type CodeableReference(Condition) Binding Codes describing complications that resulted from a procedure. ConditionProblemDiagnosisCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
followUp		0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.followUp Short description Instructions for follow up Definition If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used. Data type CodeableConcept Binding Specific follow up required for a procedure e.g. removal of sutures. ProcedureFollowUpCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
note		0..*	Annotation	There are no (further) constraints on this element Element id Bundle.entry.resource.note Short description Additional information about the procedure Definition Any other notes and comments about the procedure. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: NTE rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
focalDevice		0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice Short description Manipulated, implanted, or removed device Definition A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=DEV].role[classCode=MANU]
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
action		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.action Short description Kind of change to device Definition The kind of change that happened to the device during the procedure. Data type CodeableConcept Binding A kind of change that happened to the device during the procedure. ProcedureDeviceActionCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
manipulated		1..1	Reference(Device)	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.manipulated Short description Device that was changed Definition The device that was manipulated (changed) during the procedure. Data type Reference(Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=DEV].role[classCode=SDLOC]
used		0..*	CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct)	There are no (further) constraints on this element Element id Bundle.entry.resource.used Short description Items used during procedure Definition Identifies medications, devices and any other substance used as part of the procedure. Requirements Used for tracking contamination, etc. Comments For devices actually implanted or removed, use Procedure.focalDevice.manipulated. Data type CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct) Binding Codes describing items used during a procedure. DeviceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: participation[typeCode=Dev].role[classCode=MANU]
supportingInfo		0..*	Reference(Resource)	There are no (further) constraints on this element Element id Bundle.entry.resource.supportingInfo Short description Extra information relevant to the procedure Definition Other resources from the patient record that may be relevant to the procedure. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=PERT].target
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Substance				There are no (further) constraints on this element Element id Bundle.entry.resource.Substance
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
Observation				There are no (further) constraints on this element Element id Bundle.entry.resource.Observation
DeviceDefinition				There are no (further) constraints on this element Element id Bundle.entry.resource.DeviceDefinition
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	1..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	1..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	1..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	1..1
Type	DeviceDefinition
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.entry.resource.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.text
Short	Text summary of the resource, for human interpretation
Definition	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.
Cardinality	0..1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have a 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.
Conditions	The cardinality or value of this element may be affected by these constraints: dom-6
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
Bundle.entry.resource.contained
Short	Contained, inline Resources
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
Cardinality	0..*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5
Mappings	rim: N/A
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.modifierExtension
Short	Extensions that cannot be ignored
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.identifier
Short	External Identifiers for this procedure
Definition	Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.
Cardinality	0..*
Type	Identifier
Summary	True
Requirements	Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.
Comments	This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier v2: PR1-19 rim: .id
Bundle.entry.resource.instantiatesCanonical
Short	Instantiates FHIR protocol or definition
Definition	The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.
Cardinality	0..*
Type	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
Bundle.entry.resource.instantiatesUri
Short	Instantiates external protocol or definition
Definition	The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.
Cardinality	0..*
Type	uri
Summary	True
Comments	This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
Bundle.entry.resource.basedOn
Short	A request for this procedure
Definition	A reference to a resource that contains details of the request for this procedure.
Cardinality	0..*
Type	Reference(CarePlan \| ServiceRequest)
Summary	True
Alias	fulfills
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
Bundle.entry.resource.partOf
Short	Part of referenced event
Definition	A larger event of which this particular procedure is a component or step.
Cardinality	0..*
Type	Reference(Procedure \| Observation \| MedicationAdministration)
Summary	True
Alias	container
Comments	The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.partOf v2: PR1-25 rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
Bundle.entry.resource.status
Short	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown
Definition	A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.
Cardinality	1..1
Type	code
Binding	A code specifying the state of the procedure. EventStatus (required)
Modifier	True
Summary	True
Comments	The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status rim: statusCode
Bundle.entry.resource.statusReason
Short	Reason for current status
Definition	Captures the reason for the current state of the procedure.
Cardinality	0..1
Type	CodeableConcept
Binding	A code that identifies the reason a procedure was not performed. ProcedureNotPerformedReasonSNOMEDCT (example)
Summary	True
Alias	Suspended Reason, Cancelled Reason
Comments	This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.statusReason rim: .reason.Observation.value
Bundle.entry.resource.category
Short	Classification of the procedure
Definition	A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").
Cardinality	0..*
Type	CodeableConcept
Binding	A code that classifies a procedure for searching, sorting and display purposes. ProcedureCategoryCodesSNOMEDCT (example)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.class v2: PR1-6 rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Bundle.entry.resource.code
Short	Identification of the procedure
Definition	The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").
Cardinality	0..1
Type	CodeableConcept
Binding	A code to identify a specific procedure . ProcedureCodesSNOMEDCT (example)
Summary	True
Alias	type
Requirements	0..1 to account for primarily narrative only resources.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.code w5: FiveWs.what[x] v2: PR1-3 rim: .code
Bundle.entry.resource.subject
Short	Individual or entity the procedure was performed on
Definition	On whom or on what the procedure was performed. This is usually an individual human, but can also be performed on animals, groups of humans or animals, organizations or practitioners (for licensing), locations or devices (for safety inspections or regulatory authorizations). If the actual focus of the procedure is different from the subject, the focus element specifies the actual focus of the procedure.
Cardinality	1..1
Type	Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location)
Summary	True
Alias	patient
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role
Bundle.entry.resource.focus
Short	Who is the target of the procedure when it is not the subject of record only
Definition	Who is the target of the procedure when it is not the subject of record only. If focus is not present, then subject is the focus. If focus is present and the subject is one of the targets of the procedure, include subject as a focus as well. If focus is present and the subject is not included in focus, it implies that the procedure was only targeted on the focus. For example, when a caregiver is given education for a patient, the caregiver would be the focus and the procedure record is associated with the subject (e.g. patient). For example, use focus when recording the target of the education, training, or counseling is the parent or relative of a patient.
Cardinality	0..1
Type	Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.subject[x]
Bundle.entry.resource.encounter
Short	The Encounter during which this Procedure was created
Definition	The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.
Cardinality	0..1
Type	Reference(Encounter)
Summary	True
Comments	This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.encounter w5: FiveWs.context v2: PV1-19 rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
Bundle.entry.resource.occurrence[x]
Short	When the procedure occurred or is occurring
Definition	Estimated or actual date, date-time, period, or age when the procedure did occur or is occurring. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.
Cardinality	0..1
Type	dateTime, Period, string, Age, Range, Timing
Summary	True
Comments	This indicates when the procedure actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this Procedure is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds. Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: PR1-5 - occurrencePeriod.end can be inferred when both PR1-5 (Procedure Date/Time) and PR1-7 (Procedure Minutes) are populated rim: .effectiveTime
Bundle.entry.resource.recorded
Short	When the procedure was first captured in the subject's record
Definition	The date the occurrence of the procedure was first captured in the record regardless of Procedure.status (potentially after the occurrence of the event).
Cardinality	0..1
Type	dateTime
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.recorded w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
Bundle.entry.resource.recorder
Short	Who recorded the procedure
Definition	Individual who recorded the record and takes responsibility for its content.
Cardinality	0..1
Type	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.author rim: .participation[typeCode=AUT].role
Bundle.entry.resource.reported[x]
Short	Reported rather than primary record
Definition	Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Cardinality	0..1
Type	boolean, Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)
Summary	True
Alias	informer
Requirements	Reported data may have different rules on editing and may be visually distinguished from primary data.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reported[x] w5: FiveWs.source rim: .participation[typeCode=RPT].role
Bundle.entry.resource.performer
Short	Who performed the procedure and what they did
Definition	Indicates who or what performed the procedure and how they were involved.
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` prc-1: Procedure.performer.onBehalfOf can only be populated when performer.actor isn't Practitioner or PractitionerRole `onBehalfOf.exists() and actor.resolve().exists() implies actor.resolve().where($this is Practitioner or $this is PractitionerRole).empty()`
Mappings	workflow: Event.performer rim: .participation[typeCode=PRF]
Bundle.entry.resource.performer.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.performer.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.performer.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.performer.function
Short	Type of performance
Definition	Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.
Cardinality	0..1
Type	CodeableConcept
Binding	A code that identifies the role of a performer of the procedure. ProcedurePerformerRoleCodes (example)
Summary	True
Requirements	Allows disambiguation of the types of involvement of different performers.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.function v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25 rim: .functionCode
Bundle.entry.resource.performer.actor
Short	Who performed the procedure
Definition	Indicates who or what performed the procedure.
Cardinality	1..1
Type	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService)
Summary	True
Requirements	A reference to Device supports use cases, such as pacemakers.
Conditions	The cardinality or value of this element may be affected by these constraints: prc-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.actor w5: FiveWs.actor v2: PR1-8 (Anesthesiologist), PR1-11 (Surgeon), PR1-12 (Procedure Practitioner) --> Procedure.performer.actor where Procedure.performer.function is also populated rim: .role
Bundle.entry.resource.performer.onBehalfOf
Short	Organization the device or practitioner was acting for
Definition	The Organization the Patient, RelatedPerson, Device, CareTeam, and HealthcareService was acting on behalf of.
Cardinality	0..1
Type	Reference(Organization)
Requirements	Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.
Comments	Organization, Patient, RelatedPerson, Device, CareTeam, and HealthcareService can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.
Conditions	The cardinality or value of this element may be affected by these constraints: prc-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .scoper
Bundle.entry.resource.performer.period
Short	When the performer performed the procedure
Definition	Time period during which the performer performed the procedure.
Cardinality	0..1
Type	Period
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.location
Short	Where the procedure happened
Definition	The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.
Cardinality	0..1
Type	Reference(Location)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.where[x] v2: PR1-23 rim: .participation[typeCode=LOC].role[classCode=SDLOC]
Bundle.entry.resource.reason
Short	The justification that the procedure was performed
Definition	The coded reason or reference why the procedure was performed. This may be a coded entity of some type, be present as text, or be a reference to one of several resources that justify the procedure.
Cardinality	0..*
Type	CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)
Binding	A code that identifies the reason a procedure is required. ProcedureReasonCodes (example)
Summary	True
Comments	Use Procedure.reason.concept when a code sufficiently describes the reason. Use Procedure.reason.reference when referencing a resource, which allows more information to be conveyed, such as onset date. For a single Procedure.reason, if both Procedure.reason.concept and Procedure.reason.reference are present, they are expected to be consistent with each other.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reason w5: FiveWs.why[x] v2: PR1-15 rim: .reasonCode
Bundle.entry.resource.bodySite
Short	Target body sites
Definition	Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.
Cardinality	0..*
Type	CodeableConcept
Binding	SNOMED CT Body site concepts SNOMEDCTBodyStructures (example)
Summary	True
Comments	If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: OBX-20 rim: .targetSiteCode
Bundle.entry.resource.outcome
Short	The result of procedure
Definition	The outcome of the procedure - did it resolve the reasons for the procedure being performed?
Cardinality	0..1
Type	CodeableConcept
Binding	An outcome of a procedure - whether it was resolved or otherwise. ProcedureOutcomeCodesSNOMEDCT (example)
Summary	True
Comments	If outcome contains narrative text only, it can be captured using the CodeableConcept.text.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=OUT].target.text
Bundle.entry.resource.report
Short	Any report resulting from the procedure
Definition	This could be a histology result, pathology report, surgical report, etc.
Cardinality	0..*
Type	Reference(DiagnosticReport \| DocumentReference \| Composition)
Comments	There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
Bundle.entry.resource.complication
Short	Complication following the procedure
Definition	Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.
Cardinality	0..*
Type	CodeableReference(Condition)
Binding	Codes describing complications that resulted from a procedure. ConditionProblemDiagnosisCodes (example)
Comments	If complications are only expressed by the narrative text, they can be captured using the CodeableReference.concept.text.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Bundle.entry.resource.followUp
Short	Instructions for follow up
Definition	If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.
Cardinality	0..*
Type	CodeableConcept
Binding	Specific follow up required for a procedure e.g. removal of sutures. ProcedureFollowUpCodesSNOMEDCT (example)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
Bundle.entry.resource.note
Short	Additional information about the procedure
Definition	Any other notes and comments about the procedure.
Cardinality	0..*
Type	Annotation
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.note v2: NTE rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Bundle.entry.resource.focalDevice
Short	Manipulated, implanted, or removed device
Definition	A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.
Cardinality	0..*
Type	BackboneElement
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .participation[typeCode=DEV].role[classCode=MANU]
Bundle.entry.resource.focalDevice.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.focalDevice.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.focalDevice.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.focalDevice.action
Short	Kind of change to device
Definition	The kind of change that happened to the device during the procedure.
Cardinality	0..1
Type	CodeableConcept
Binding	A kind of change that happened to the device during the procedure. ProcedureDeviceActionCodes (preferred)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
Bundle.entry.resource.focalDevice.manipulated
Short	Device that was changed
Definition	The device that was manipulated (changed) during the procedure.
Cardinality	1..1
Type	Reference(Device)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .participation[typeCode=DEV].role[classCode=SDLOC]
Bundle.entry.resource.used
Short	Items used during procedure
Definition	Identifies medications, devices and any other substance used as part of the procedure.
Cardinality	0..*
Type	CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct)
Binding	Codes describing items used during a procedure. DeviceType (example)
Requirements	Used for tracking contamination, etc.
Comments	For devices actually implanted or removed, use Procedure.focalDevice.manipulated.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: participation[typeCode=Dev].role[classCode=MANU]
Bundle.entry.resource.supportingInfo
Short	Extra information relevant to the procedure
Definition	Other resources from the patient record that may be relevant to the procedure. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available.
Cardinality	0..*
Type	Reference(Resource)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=PERT].target
Bundle.entry.resource.Procedure
Bundle.entry.resource.Substance
Bundle.entry.resource.Device
Bundle.entry.resource.Observation
Bundle.entry.resource.DeviceDefinition
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

<id value="DisinfectionCycle" />
<url value="https://example.org/fhir/StructureDefinition/DisinfectionCycle" />
<version value="1.0.0" />
<name value="DisinfectionCycle" />
<status value="active" />
<date value="2024-11-19" />
<description value="A profile defining the structure and constraints for the Disinfection Cycle Bundle containing procedures, substances, devices, observations, and related resources." />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<differential>
<element id="Bundle.identifier">
<path value="Bundle.identifier" />
<min value="1" />
<type>
<code value="Identifier" />
</type>
</element>
<element id="Bundle.type">
<path value="Bundle.type" />
<fixedCode value="collection" />
</element>
<element id="Bundle.entry">
<path value="Bundle.entry" />
<min value="1" />
<type>
<code value="BackboneElement" />
</type>
</element>
<element id="Bundle.entry.fullUrl">
<path value="Bundle.entry.fullUrl" />
<min value="1" />
<type>
<code value="uri" />
</type>
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<min value="1" />
<type>
<code value="Resource" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.subject">
<path value="Bundle.entry.resource.Procedure.subject" />
<min value="1" />
<type>
<code value="Reference" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<type>
<code value="code" />
</type>
</element>
<element id="Bundle.entry.resource.Substance">
<path value="Bundle.entry.resource" />
<type>
<code value="Substance" />
</type>
</element>
<element id="Bundle.entry.resource.Substance.code">
<path value="Bundle.entry.resource.Substance.code" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
</element>
<element id="Bundle.entry.resource.Organization">
<path value="Bundle.entry.resource" />
<type>
<code value="Organization" />
</type>
</element>
<element id="Bundle.entry.resource.Practitioner">
<path value="Bundle.entry.resource" />
<type>
<code value="Practitioner" />
</type>
</element>
<element id="Bundle.entry.resource.Device">
<path value="Bundle.entry.resource" />
<type>
<code value="Device" />
</type>
</element>
<element id="Bundle.entry.resource.Device.serialNumber">
<path value="Bundle.entry.resource.Device.serialNumber" />
<min value="1" />
<type>
<code value="string" />
</type>
</element>
<element id="Bundle.entry.resource.Observation">
<path value="Bundle.entry.resource" />
<type>
<code value="Observation" />
</type>
</element>
<element id="Bundle.entry.resource.Observation.status">
<path value="Bundle.entry.resource.Observation.status" />
<min value="1" />
<type>
<code value="code" />
</type>
</element>
<element id="Bundle.entry.resource.Observation.code">
<path value="Bundle.entry.resource.Observation.code" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
</element>
<element id="Bundle.entry.resource.DeviceDefinition">
<path value="Bundle.entry.resource" />
<type>
<code value="DeviceDefinition" />
</type>
</element>
<element id="Bundle.entry.resource.DeviceDefinition.identifier">
<path value="Bundle.entry.resource.DeviceDefinition.identifier" />
<min value="1" />
<type>
<code value="Identifier" />
</type>
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "DisinfectionCycle",
"url": "https://example.org/fhir/StructureDefinition/DisinfectionCycle",
"version": "1.0.0",
"name": "DisinfectionCycle",
"status": "active",
"date": "2024-11-19",
"description": "A profile defining the structure and constraints for the Disinfection Cycle Bundle containing procedures, substances, devices, observations, and related resources.",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"differential": {
"element": [
{
"id": "Bundle.identifier",
"path": "Bundle.identifier",
"min": 1,
"type": [
{
"code": "Identifier"
}
]
},
{
"id": "Bundle.type",
"path": "Bundle.type",
"fixedCode": "collection"
},
{
"id": "Bundle.entry",
"path": "Bundle.entry",
"min": 1,
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "Bundle.entry.fullUrl",
"path": "Bundle.entry.fullUrl",
"min": 1,
"type": [
{
"code": "uri"
}
]
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"min": 1,
"type": [
{
"code": "Resource"
}
]
},
{
"id": "Bundle.entry.resource.Procedure",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.subject",
"path": "Bundle.entry.resource.Procedure.subject",
"min": 1,
"type": [
{
"code": "Reference"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"type": [
{
"code": "code"
}
]
},
{
"id": "Bundle.entry.resource.Substance",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Substance"
}
]
},
{
"id": "Bundle.entry.resource.Substance.code",
"path": "Bundle.entry.resource.Substance.code",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "Bundle.entry.resource.Organization",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Organization"
}
]
},
{
"id": "Bundle.entry.resource.Practitioner",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Practitioner"
}
]
},
{
"id": "Bundle.entry.resource.Device",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Device"
}
]
},
{
"id": "Bundle.entry.resource.Device.serialNumber",
"path": "Bundle.entry.resource.Device.serialNumber",
"min": 1,
"type": [
{
"code": "string"
}
]
},
{
"id": "Bundle.entry.resource.Observation",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Observation"
}
]
},
{
"id": "Bundle.entry.resource.Observation.status",
"path": "Bundle.entry.resource.Observation.status",
"min": 1,
"type": [
{
"code": "code"
}
]
},
{
"id": "Bundle.entry.resource.Observation.code",
"path": "Bundle.entry.resource.Observation.code",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "Bundle.entry.resource.DeviceDefinition",
"path": "Bundle.entry.resource",
"type": [
{
"code": "DeviceDefinition"
}
]
},
{
"id": "Bundle.entry.resource.DeviceDefinition.identifier",
"path": "Bundle.entry.resource.DeviceDefinition.identifier",
"min": 1,
"type": [
{
"code": "Identifier"
}
]
}
]
}

}

Firmware Replaced

FirmwareReplaced (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	1..1	Identifier	Element id Bundle.identifier Short description An identifier for the Bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
id		0..1	id	There are no (further) constraints on this element Element id Bundle.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	1..1	CodeableConceptBindingFixed Value	Element id Bundle.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. IdentifierTypeCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value { "text": "Firmware Replaced" } Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique. 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. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ C	0..1	string	There are no (further) constraints on this element Element id Bundle.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ident-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Bundle.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Bundle.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description Must be of type 'collection' Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	1..*	BackboneElement	Element id Bundle.entry Short description Entries in the bundle Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	1..1	uri	Element id Bundle.entry.fullUrl Short description Full URL for the entry Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	1..1	Device	Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Device Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.entry.resource.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.resource.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text	C	0..1	Narrative	There are no (further) constraints on this element Element id Bundle.entry.resource.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments Contained resources do not have a 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. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: dom-6 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained	C	0..*	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. Comments 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. Data type Resource Conditions The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5 Mappings rim: N/A
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Bundle.entry.resource.identifier Short description External Identifiers for this procedure Definition Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server. Requirements Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier v2: PR1-19 rim: .id
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)	There are no (further) constraints on this element Element id Bundle.entry.resource.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure. Data type canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id Bundle.entry.resource.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ	0..*	Reference(CarePlan \| ServiceRequest)	There are no (further) constraints on this element Element id Bundle.entry.resource.basedOn Short description A request for this procedure Alternate names fulfills Definition A reference to a resource that contains details of the request for this procedure. Data type Reference(CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
partOf	Σ	0..*	Reference(Procedure \| Observation \| MedicationAdministration)	There are no (further) constraints on this element Element id Bundle.entry.resource.partOf Short description Part of referenced event Alternate names container Definition A larger event of which this particular procedure is a component or step. Comments The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration). Data type Reference(Procedure \| Observation \| MedicationAdministration) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf v2: PR1-25 rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.status Short description preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Definition A code specifying the state of the procedure. Generally, this will be the in-progress or completed state. Comments The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A code specifying the state of the procedure. EventStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: statusCode
statusReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.statusReason Short description Reason for current status Alternate names Suspended Reason, Cancelled Reason Definition Captures the reason for the current state of the procedure. Comments This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here. Data type CodeableConcept Binding A code that identifies the reason a procedure was not performed. ProcedureNotPerformedReasonSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason rim: .reason.Observation.value
category	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.category Short description Classification of the procedure Definition A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure"). Data type CodeableConcept Binding A code that classifies a procedure for searching, sorting and display purposes. ProcedureCategoryCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class v2: PR1-6 rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
code	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.code Short description Identification of the procedure Alternate names type Definition The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy"). Requirements 0..1 to account for primarily narrative only resources. Data type CodeableConcept Binding A code to identify a specific procedure . ProcedureCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] v2: PR1-3 rim: .code
subject	Σ	1..1	Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location)	There are no (further) constraints on this element Element id Bundle.entry.resource.subject Short description Individual or entity the procedure was performed on Alternate names patient Definition On whom or on what the procedure was performed. This is usually an individual human, but can also be performed on animals, groups of humans or animals, organizations or practitioners (for licensing), locations or devices (for safety inspections or regulatory authorizations). If the actual focus of the procedure is different from the subject, the focus element specifies the actual focus of the procedure. Data type Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role
focus	Σ	0..1	Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen)	There are no (further) constraints on this element Element id Bundle.entry.resource.focus Short description Who is the target of the procedure when it is not the subject of record only Definition Who is the target of the procedure when it is not the subject of record only. If focus is not present, then subject is the focus. If focus is present and the subject is one of the targets of the procedure, include subject as a focus as well. If focus is present and the subject is not included in focus, it implies that the procedure was only targeted on the focus. For example, when a caregiver is given education for a patient, the caregiver would be the focus and the procedure record is associated with the subject (e.g. patient). For example, use focus when recording the target of the education, training, or counseling is the parent or relative of a patient. Data type Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.subject[x]
encounter	Σ	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Bundle.entry.resource.encounter Short description The Encounter during which this Procedure was created Definition The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context v2: PV1-19 rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
occurrence[x]	Σ	0..1		There are no (further) constraints on this element Element id Bundle.entry.resource.occurrence[x] Short description When the procedure occurred or is occurring Definition Estimated or actual date, date-time, period, or age when the procedure did occur or is occurring. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured. Comments This indicates when the procedure actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this Procedure is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds. Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: PR1-5 - occurrencePeriod.end can be inferred when both PR1-5 (Procedure Date/Time) and PR1-7 (Procedure Minutes) are populated rim: .effectiveTime
occurrenceDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
occurrencePeriod			Period	There are no (further) constraints on this element Data type Period
occurrenceString			string	There are no (further) constraints on this element Data type string
occurrenceAge			Age	There are no (further) constraints on this element Data type Age
occurrenceRange			Range	There are no (further) constraints on this element Data type Range
occurrenceTiming			Timing	There are no (further) constraints on this element Data type Timing
recorded	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Bundle.entry.resource.recorded Short description When the procedure was first captured in the subject's record Definition The date the occurrence of the procedure was first captured in the record regardless of Procedure.status (potentially after the occurrence of the event). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.recorded w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
recorder	Σ	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Bundle.entry.resource.recorder Short description Who recorded the procedure Definition Individual who recorded the record and takes responsibility for its content. Data type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.author rim: .participation[typeCode=AUT].role
reported[x]	Σ	0..1		There are no (further) constraints on this element Element id Bundle.entry.resource.reported[x] Short description Reported rather than primary record Alternate names informer Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Requirements Reported data may have different rules on editing and may be visually distinguished from primary data. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reported[x] w5: FiveWs.source rim: .participation[typeCode=RPT].role
reportedBoolean			boolean	There are no (further) constraints on this element Data type boolean
reportedReference			Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)	There are no (further) constraints on this element Data type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)
performer	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.resource.performer Short description Who performed the procedure and what they did Definition Indicates who or what performed the procedure and how they were involved. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` prc-1: Procedure.performer.onBehalfOf can only be populated when performer.actor isn't Practitioner or PractitionerRole `onBehalfOf.exists() and actor.resolve().exists() implies actor.resolve().where($this is Practitioner or $this is PractitionerRole).empty()` Mappings workflow: Event.performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. Requirements Allows disambiguation of the types of involvement of different performers. Data type CodeableConcept Binding A code that identifies the role of a performer of the procedure. ProcedurePerformerRoleCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.function v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25 rim: .functionCode
actor	Σ C	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService)	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.actor Short description Who performed the procedure Definition Indicates who or what performed the procedure. Requirements A reference to Device supports use cases, such as pacemakers. Data type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService) Conditions The cardinality or value of this element may be affected by these constraints: prc-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor v2: PR1-8 (Anesthesiologist), PR1-11 (Surgeon), PR1-12 (Procedure Practitioner) --> Procedure.performer.actor where Procedure.performer.function is also populated rim: .role
onBehalfOf	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.onBehalfOf Short description Organization the device or practitioner was acting for Definition The Organization the Patient, RelatedPerson, Device, CareTeam, and HealthcareService was acting on behalf of. Requirements Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action. Comments Organization, Patient, RelatedPerson, Device, CareTeam, and HealthcareService can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: prc-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .scoper
period		0..1	Period	There are no (further) constraints on this element Element id Bundle.entry.resource.performer.period Short description When the performer performed the procedure Definition Time period during which the performer performed the procedure. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	Reference(Location)	There are no (further) constraints on this element Element id Bundle.entry.resource.location Short description Where the procedure happened Definition The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.where[x] v2: PR1-23 rim: .participation[typeCode=LOC].role[classCode=SDLOC]
reason	Σ	0..*	CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id Bundle.entry.resource.reason Short description The justification that the procedure was performed Definition The coded reason or reference why the procedure was performed. This may be a coded entity of some type, be present as text, or be a reference to one of several resources that justify the procedure. Comments Use Procedure.reason.concept when a code sufficiently describes the reason. Use Procedure.reason.reference when referencing a resource, which allows more information to be conveyed, such as onset date. For a single Procedure.reason, if both Procedure.reason.concept and Procedure.reason.reference are present, they are expected to be consistent with each other. Data type CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference) Binding A code that identifies the reason a procedure is required. ProcedureReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reason w5: FiveWs.why[x] v2: PR1-15 rim: .reasonCode
bodySite	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.bodySite Short description Target body sites Definition Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure. Data type CodeableConcept Binding SNOMED CT Body site concepts SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-20 rim: .targetSiteCode
outcome	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.outcome Short description The result of procedure Definition The outcome of the procedure - did it resolve the reasons for the procedure being performed? Comments If outcome contains narrative text only, it can be captured using the CodeableConcept.text. Data type CodeableConcept Binding An outcome of a procedure - whether it was resolved or otherwise. ProcedureOutcomeCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=OUT].target.text
report		0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	There are no (further) constraints on this element Element id Bundle.entry.resource.report Short description Any report resulting from the procedure Definition This could be a histology result, pathology report, surgical report, etc. Comments There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports. Data type Reference(DiagnosticReport \| DocumentReference \| Composition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
complication		0..*	CodeableReference(Condition)	There are no (further) constraints on this element Element id Bundle.entry.resource.complication Short description Complication following the procedure Definition Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues. Comments If complications are only expressed by the narrative text, they can be captured using the CodeableReference.concept.text. Data type CodeableReference(Condition) Binding Codes describing complications that resulted from a procedure. ConditionProblemDiagnosisCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
followUp		0..*	CodeableConcept	There are no (further) constraints on this element Element id Bundle.entry.resource.followUp Short description Instructions for follow up Definition If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used. Data type CodeableConcept Binding Specific follow up required for a procedure e.g. removal of sutures. ProcedureFollowUpCodesSNOMEDCT (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
note		0..*	Annotation	There are no (further) constraints on this element Element id Bundle.entry.resource.note Short description Additional information about the procedure Definition Any other notes and comments about the procedure. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: NTE rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
focalDevice		0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice Short description Manipulated, implanted, or removed device Definition A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=DEV].role[classCode=MANU]
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
action		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.action Short description Kind of change to device Definition The kind of change that happened to the device during the procedure. Data type CodeableConcept Binding A kind of change that happened to the device during the procedure. ProcedureDeviceActionCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
manipulated		1..1	Reference(Device)	There are no (further) constraints on this element Element id Bundle.entry.resource.focalDevice.manipulated Short description Device that was changed Definition The device that was manipulated (changed) during the procedure. Data type Reference(Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=DEV].role[classCode=SDLOC]
used		0..*	CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct)	There are no (further) constraints on this element Element id Bundle.entry.resource.used Short description Items used during procedure Definition Identifies medications, devices and any other substance used as part of the procedure. Requirements Used for tracking contamination, etc. Comments For devices actually implanted or removed, use Procedure.focalDevice.manipulated. Data type CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct) Binding Codes describing items used during a procedure. DeviceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: participation[typeCode=Dev].role[classCode=MANU]
supportingInfo		0..*	Reference(Resource)	There are no (further) constraints on this element Element id Bundle.entry.resource.supportingInfo Short description Extra information relevant to the procedure Definition Other resources from the patient record that may be relevant to the procedure. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=PERT].target
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	An identifier for the Bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	1..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.identifier.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	id
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.identifier.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.identifier.use
Short	usual \| official \| temp \| secondary \| old (If known)
Definition	The purpose of this identifier.
Cardinality	0..1
Type	code
Binding	Identifies the purpose for this identifier, if known . IdentifierUse (required)
Modifier	True
Summary	True
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: N/A rim: Role.code or implied by context
Bundle.identifier.type
Short	Description of identifier
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality	1..1
Type	CodeableConcept
Binding	A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. IdentifierTypeCodes (extensible)
Summary	True
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	{ "text": "Firmware Replaced" }
Mappings	v2: CX.5 rim: Role.code or implied by context
Bundle.identifier.system
Short	The namespace for the identifier value
Definition	Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Cardinality	0..1
Type	uri
Summary	True
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.
Comments	Identifier.system is always case sensitive.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General http://www.acme.com/identifiers/patient
Mappings	v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
Bundle.identifier.value
Short	The value that is unique
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality	0..1
Type	string
Summary	True
Comments	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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.
Conditions	The cardinality or value of this element may be affected by these constraints: ident-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 123456
Mappings	v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
Bundle.identifier.period
Short	Time period when id is/was valid for use
Definition	Time period during which identifier is/was valid for use.
Cardinality	0..1
Type	Period
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
Bundle.identifier.assigner
Short	Organization that issued id (may be just text)
Definition	Organization that issued/manages the identifier.
Cardinality	0..1
Type	Reference(Organization)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
Bundle.type
Short	Must be of type 'collection'
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entries in the bundle
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	1..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	Full URL for the entry
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	1..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	1..1
Type	Device
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.entry.resource.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.text
Short	Text summary of the resource, for human interpretation
Definition	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.
Cardinality	0..1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have a 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.
Conditions	The cardinality or value of this element may be affected by these constraints: dom-6
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
Bundle.entry.resource.contained
Short	Contained, inline Resources
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
Cardinality	0..*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5
Mappings	rim: N/A
Bundle.entry.resource.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.modifierExtension
Short	Extensions that cannot be ignored
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.identifier
Short	External Identifiers for this procedure
Definition	Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.
Cardinality	0..*
Type	Identifier
Summary	True
Requirements	Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.
Comments	This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier v2: PR1-19 rim: .id
Bundle.entry.resource.instantiatesCanonical
Short	Instantiates FHIR protocol or definition
Definition	The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.
Cardinality	0..*
Type	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
Bundle.entry.resource.instantiatesUri
Short	Instantiates external protocol or definition
Definition	The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.
Cardinality	0..*
Type	uri
Summary	True
Comments	This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
Bundle.entry.resource.basedOn
Short	A request for this procedure
Definition	A reference to a resource that contains details of the request for this procedure.
Cardinality	0..*
Type	Reference(CarePlan \| ServiceRequest)
Summary	True
Alias	fulfills
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
Bundle.entry.resource.partOf
Short	Part of referenced event
Definition	A larger event of which this particular procedure is a component or step.
Cardinality	0..*
Type	Reference(Procedure \| Observation \| MedicationAdministration)
Summary	True
Alias	container
Comments	The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.partOf v2: PR1-25 rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
Bundle.entry.resource.status
Short	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown
Definition	A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.
Cardinality	1..1
Type	code
Binding	A code specifying the state of the procedure. EventStatus (required)
Modifier	True
Summary	True
Comments	The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status rim: statusCode
Bundle.entry.resource.statusReason
Short	Reason for current status
Definition	Captures the reason for the current state of the procedure.
Cardinality	0..1
Type	CodeableConcept
Binding	A code that identifies the reason a procedure was not performed. ProcedureNotPerformedReasonSNOMEDCT (example)
Summary	True
Alias	Suspended Reason, Cancelled Reason
Comments	This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.statusReason rim: .reason.Observation.value
Bundle.entry.resource.category
Short	Classification of the procedure
Definition	A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").
Cardinality	0..*
Type	CodeableConcept
Binding	A code that classifies a procedure for searching, sorting and display purposes. ProcedureCategoryCodesSNOMEDCT (example)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.class v2: PR1-6 rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Bundle.entry.resource.code
Short	Identification of the procedure
Definition	The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").
Cardinality	0..1
Type	CodeableConcept
Binding	A code to identify a specific procedure . ProcedureCodesSNOMEDCT (example)
Summary	True
Alias	type
Requirements	0..1 to account for primarily narrative only resources.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.code w5: FiveWs.what[x] v2: PR1-3 rim: .code
Bundle.entry.resource.subject
Short	Individual or entity the procedure was performed on
Definition	On whom or on what the procedure was performed. This is usually an individual human, but can also be performed on animals, groups of humans or animals, organizations or practitioners (for licensing), locations or devices (for safety inspections or regulatory authorizations). If the actual focus of the procedure is different from the subject, the focus element specifies the actual focus of the procedure.
Cardinality	1..1
Type	Reference(Patient \| Group \| Device \| Practitioner \| Organization \| Location)
Summary	True
Alias	patient
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role
Bundle.entry.resource.focus
Short	Who is the target of the procedure when it is not the subject of record only
Definition	Who is the target of the procedure when it is not the subject of record only. If focus is not present, then subject is the focus. If focus is present and the subject is one of the targets of the procedure, include subject as a focus as well. If focus is present and the subject is not included in focus, it implies that the procedure was only targeted on the focus. For example, when a caregiver is given education for a patient, the caregiver would be the focus and the procedure record is associated with the subject (e.g. patient). For example, use focus when recording the target of the education, training, or counseling is the parent or relative of a patient.
Cardinality	0..1
Type	Reference(Patient \| Group \| RelatedPerson \| Practitioner \| Organization \| CareTeam \| PractitionerRole \| Specimen)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.subject[x]
Bundle.entry.resource.encounter
Short	The Encounter during which this Procedure was created
Definition	The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.
Cardinality	0..1
Type	Reference(Encounter)
Summary	True
Comments	This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.encounter w5: FiveWs.context v2: PV1-19 rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
Bundle.entry.resource.occurrence[x]
Short	When the procedure occurred or is occurring
Definition	Estimated or actual date, date-time, period, or age when the procedure did occur or is occurring. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.
Cardinality	0..1
Type	dateTime, Period, string, Age, Range, Timing
Summary	True
Comments	This indicates when the procedure actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this Procedure is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds. Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: PR1-5 - occurrencePeriod.end can be inferred when both PR1-5 (Procedure Date/Time) and PR1-7 (Procedure Minutes) are populated rim: .effectiveTime
Bundle.entry.resource.recorded
Short	When the procedure was first captured in the subject's record
Definition	The date the occurrence of the procedure was first captured in the record regardless of Procedure.status (potentially after the occurrence of the event).
Cardinality	0..1
Type	dateTime
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.recorded w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
Bundle.entry.resource.recorder
Short	Who recorded the procedure
Definition	Individual who recorded the record and takes responsibility for its content.
Cardinality	0..1
Type	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.author rim: .participation[typeCode=AUT].role
Bundle.entry.resource.reported[x]
Short	Reported rather than primary record
Definition	Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Cardinality	0..1
Type	boolean, Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization)
Summary	True
Alias	informer
Requirements	Reported data may have different rules on editing and may be visually distinguished from primary data.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reported[x] w5: FiveWs.source rim: .participation[typeCode=RPT].role
Bundle.entry.resource.performer
Short	Who performed the procedure and what they did
Definition	Indicates who or what performed the procedure and how they were involved.
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` prc-1: Procedure.performer.onBehalfOf can only be populated when performer.actor isn't Practitioner or PractitionerRole `onBehalfOf.exists() and actor.resolve().exists() implies actor.resolve().where($this is Practitioner or $this is PractitionerRole).empty()`
Mappings	workflow: Event.performer rim: .participation[typeCode=PRF]
Bundle.entry.resource.performer.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.performer.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.performer.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.performer.function
Short	Type of performance
Definition	Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.
Cardinality	0..1
Type	CodeableConcept
Binding	A code that identifies the role of a performer of the procedure. ProcedurePerformerRoleCodes (example)
Summary	True
Requirements	Allows disambiguation of the types of involvement of different performers.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.function v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25 rim: .functionCode
Bundle.entry.resource.performer.actor
Short	Who performed the procedure
Definition	Indicates who or what performed the procedure.
Cardinality	1..1
Type	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| CareTeam \| HealthcareService)
Summary	True
Requirements	A reference to Device supports use cases, such as pacemakers.
Conditions	The cardinality or value of this element may be affected by these constraints: prc-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.actor w5: FiveWs.actor v2: PR1-8 (Anesthesiologist), PR1-11 (Surgeon), PR1-12 (Procedure Practitioner) --> Procedure.performer.actor where Procedure.performer.function is also populated rim: .role
Bundle.entry.resource.performer.onBehalfOf
Short	Organization the device or practitioner was acting for
Definition	The Organization the Patient, RelatedPerson, Device, CareTeam, and HealthcareService was acting on behalf of.
Cardinality	0..1
Type	Reference(Organization)
Requirements	Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.
Comments	Organization, Patient, RelatedPerson, Device, CareTeam, and HealthcareService can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.
Conditions	The cardinality or value of this element may be affected by these constraints: prc-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .scoper
Bundle.entry.resource.performer.period
Short	When the performer performed the procedure
Definition	Time period during which the performer performed the procedure.
Cardinality	0..1
Type	Period
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.location
Short	Where the procedure happened
Definition	The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.
Cardinality	0..1
Type	Reference(Location)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.where[x] v2: PR1-23 rim: .participation[typeCode=LOC].role[classCode=SDLOC]
Bundle.entry.resource.reason
Short	The justification that the procedure was performed
Definition	The coded reason or reference why the procedure was performed. This may be a coded entity of some type, be present as text, or be a reference to one of several resources that justify the procedure.
Cardinality	0..*
Type	CodeableReference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)
Binding	A code that identifies the reason a procedure is required. ProcedureReasonCodes (example)
Summary	True
Comments	Use Procedure.reason.concept when a code sufficiently describes the reason. Use Procedure.reason.reference when referencing a resource, which allows more information to be conveyed, such as onset date. For a single Procedure.reason, if both Procedure.reason.concept and Procedure.reason.reference are present, they are expected to be consistent with each other.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reason w5: FiveWs.why[x] v2: PR1-15 rim: .reasonCode
Bundle.entry.resource.bodySite
Short	Target body sites
Definition	Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.
Cardinality	0..*
Type	CodeableConcept
Binding	SNOMED CT Body site concepts SNOMEDCTBodyStructures (example)
Summary	True
Comments	If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: OBX-20 rim: .targetSiteCode
Bundle.entry.resource.outcome
Short	The result of procedure
Definition	The outcome of the procedure - did it resolve the reasons for the procedure being performed?
Cardinality	0..1
Type	CodeableConcept
Binding	An outcome of a procedure - whether it was resolved or otherwise. ProcedureOutcomeCodesSNOMEDCT (example)
Summary	True
Comments	If outcome contains narrative text only, it can be captured using the CodeableConcept.text.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=OUT].target.text
Bundle.entry.resource.report
Short	Any report resulting from the procedure
Definition	This could be a histology result, pathology report, surgical report, etc.
Cardinality	0..*
Type	Reference(DiagnosticReport \| DocumentReference \| Composition)
Comments	There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
Bundle.entry.resource.complication
Short	Complication following the procedure
Definition	Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.
Cardinality	0..*
Type	CodeableReference(Condition)
Binding	Codes describing complications that resulted from a procedure. ConditionProblemDiagnosisCodes (example)
Comments	If complications are only expressed by the narrative text, they can be captured using the CodeableReference.concept.text.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
Bundle.entry.resource.followUp
Short	Instructions for follow up
Definition	If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.
Cardinality	0..*
Type	CodeableConcept
Binding	Specific follow up required for a procedure e.g. removal of sutures. ProcedureFollowUpCodesSNOMEDCT (example)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
Bundle.entry.resource.note
Short	Additional information about the procedure
Definition	Any other notes and comments about the procedure.
Cardinality	0..*
Type	Annotation
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.note v2: NTE rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Bundle.entry.resource.focalDevice
Short	Manipulated, implanted, or removed device
Definition	A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.
Cardinality	0..*
Type	BackboneElement
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .participation[typeCode=DEV].role[classCode=MANU]
Bundle.entry.resource.focalDevice.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.resource.focalDevice.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.resource.focalDevice.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.resource.focalDevice.action
Short	Kind of change to device
Definition	The kind of change that happened to the device during the procedure.
Cardinality	0..1
Type	CodeableConcept
Binding	A kind of change that happened to the device during the procedure. ProcedureDeviceActionCodes (preferred)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
Bundle.entry.resource.focalDevice.manipulated
Short	Device that was changed
Definition	The device that was manipulated (changed) during the procedure.
Cardinality	1..1
Type	Reference(Device)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .participation[typeCode=DEV].role[classCode=SDLOC]
Bundle.entry.resource.used
Short	Items used during procedure
Definition	Identifies medications, devices and any other substance used as part of the procedure.
Cardinality	0..*
Type	CodeableReference(Device \| Medication \| Substance \| BiologicallyDerivedProduct)
Binding	Codes describing items used during a procedure. DeviceType (example)
Requirements	Used for tracking contamination, etc.
Comments	For devices actually implanted or removed, use Procedure.focalDevice.manipulated.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: participation[typeCode=Dev].role[classCode=MANU]
Bundle.entry.resource.supportingInfo
Short	Extra information relevant to the procedure
Definition	Other resources from the patient record that may be relevant to the procedure. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available.
Cardinality	0..*
Type	Reference(Resource)
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=PERT].target
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

<id value="FirmwareReplaced" />
<url value="http://simplifier.net/fhir/StructureDefinition/FirmwareReplaced" />
<version value="1.0.0" />
<name value="FirmwareReplaced" />
<title value="Firmware Replaced" />
<status value="draft" />
<date value="2024-11-19" />
<description value="A profile for firmware replacement activities using FHIR R5." />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.identifier">
<path value="Bundle.identifier" />
<short value="An identifier for the Bundle" />
<min value="1" />
<type>
<code value="Identifier" />
</type>
</element>
<element id="Bundle.identifier.type">
<path value="Bundle.identifier.type" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<fixedCodeableConcept>
<text value="Firmware Replaced" />
</fixedCodeableConcept>
</element>
<element id="Bundle.type">
<path value="Bundle.type" />
<short value="Must be of type 'collection'" />
<min value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.entry">
<path value="Bundle.entry" />
<short value="Entries in the bundle" />
<min value="1" />
<type>
<code value="BackboneElement" />
</type>
</element>
<element id="Bundle.entry.fullUrl">
<path value="Bundle.entry.fullUrl" />
<short value="Full URL for the entry" />
<min value="1" />
<type>
<code value="uri" />
</type>
</element>
<element id="Bundle.entry.resource">
<path value="Bundle.entry.resource" />
<min value="1" />
<type>
<code value="Resource" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure">
<path value="Bundle.entry.resource" />
<type>
<code value="Procedure" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.subject">
<path value="Bundle.entry.resource.Procedure.subject" />
<min value="1" />
<type>
<code value="Reference" />
</type>
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<fixedCode value="completed" />
</element>
<element id="Bundle.entry.resource.Procedure.outcome">
<path value="Bundle.entry.resource.Procedure.outcome" />
<type>
<code value="CodeableConcept" />
</type>
</element>
<element id="Bundle.entry.resource.Device">
<path value="Bundle.entry.resource" />
<type>
<code value="Device" />
</type>
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
<type>
<code value="string" />
</type>
</element>
<element id="Bundle.entry.resource.Device.serialNumber">
<path value="Bundle.entry.resource.Device.serialNumber" />
<min value="1" />
<type>
<code value="string" />
</type>
</element>
<element id="Bundle.entry.resource.Device.version">
<path value="Bundle.entry.resource.Device.version" />
<min value="1" />
<type>
<code value="BackboneElement" />
</type>
</element>
<element id="Bundle.entry.resource.Device.version.type">
<path value="Bundle.entry.resource.Device.version.type" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
</element>
<element id="Bundle.entry.resource.Device.version.value">
<path value="Bundle.entry.resource.Device.version.value" />
<min value="1" />
<type>
<code value="string" />
</type>
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "FirmwareReplaced",
"url": "http://simplifier.net/fhir/StructureDefinition/FirmwareReplaced",
"version": "1.0.0",
"name": "FirmwareReplaced",
"title": "Firmware Replaced",
"status": "draft",
"date": "2024-11-19",
"description": "A profile for firmware replacement activities using FHIR R5.",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.identifier",
"path": "Bundle.identifier",
"min": 1,
"type": [
{
"code": "Identifier"
}
],
"short": "An identifier for the Bundle"
},
{
"id": "Bundle.identifier.type",
"path": "Bundle.identifier.type",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"fixedCodeableConcept": {
"text": "Firmware Replaced"
}
},
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"fixedCode": "collection",
"short": "Must be of type 'collection'"
},
{
"id": "Bundle.entry",
"path": "Bundle.entry",
"min": 1,
"type": [
{
"code": "BackboneElement"
}
],
"short": "Entries in the bundle"
},
{
"id": "Bundle.entry.fullUrl",
"path": "Bundle.entry.fullUrl",
"min": 1,
"type": [
{
"code": "uri"
}
],
"short": "Full URL for the entry"
},
{
"id": "Bundle.entry.resource",
"path": "Bundle.entry.resource",
"min": 1,
"type": [
{
"code": "Resource"
}
]
},
{
"id": "Bundle.entry.resource.Procedure",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Procedure"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.subject",
"path": "Bundle.entry.resource.Procedure.subject",
"min": 1,
"type": [
{
"code": "Reference"
}
]
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"fixedCode": "completed"
},
{
"id": "Bundle.entry.resource.Procedure.outcome",
"path": "Bundle.entry.resource.Procedure.outcome",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "Bundle.entry.resource.Device",
"path": "Bundle.entry.resource",
"type": [
{
"code": "Device"
}
]
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1,
"type": [
{
"code": "string"
}
]
},
{
"id": "Bundle.entry.resource.Device.serialNumber",
"path": "Bundle.entry.resource.Device.serialNumber",
"min": 1,
"type": [
{
"code": "string"
}
]
},
{
"id": "Bundle.entry.resource.Device.version",
"path": "Bundle.entry.resource.Device.version",
"min": 1,
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "Bundle.entry.resource.Device.version.type",
"path": "Bundle.entry.resource.Device.version.type",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "Bundle.entry.resource.Device.version.value",
"path": "Bundle.entry.resource.Device.version.value",
"min": 1,
"type": [
{
"code": "string"
}
]
}
]
}

}

Annual Calibration and Conductivity Probe Replaced

AnnualCalibrationConductivityProbeReplaced (Bundle)	C		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())` Mappings rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ C	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: bdl-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
id		0..1	id	There are no (further) constraints on this element Element id Bundle.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Bundle.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. IdentifierTypeCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
id		0..1	id	There are no (further) constraints on this element Element id Bundle.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Bundle.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	1..1	stringFixed Value	Element id Bundle.identifier.type.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value Annual Calibration and Conductivity Probe Replaced Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique. 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. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ C	0..1	string	There are no (further) constraints on this element Element id Bundle.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ident-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Bundle.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Bundle.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
type	Σ C	1..1	codeBindingFixed Value	Element id Bundle.type Short description document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification Definition Indicates the purpose of this bundle - how it is intended to be used. Comments 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. Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value collection Mappings w5: FiveWs.class
timestamp	Σ C	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments 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. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: bdl-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ C	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the (potentially estimated) 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. Comments 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. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: bdl-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relation	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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. Data type code Binding LinkRelationTypes (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-18 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ C	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ C	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.) Definition The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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). Data type uri Conditions The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ C	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning. Data type Resource Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
id	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.entry.resource.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.entry.resource.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.resource.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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 its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.resource.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resourceType			Pattern	There are no (further) constraints on this element Element id Bundle.entry.resource.resourceType Pattern Procedure \| Device
Procedure				There are no (further) constraints on this element Element id Bundle.entry.resource.Procedure
Device				There are no (further) constraints on this element Element id Bundle.entry.resource.Device
search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include - why this is in the result set 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. Comments 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. Data type code Binding 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. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments 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 for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH 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. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Conditions The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments 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]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache validation Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates 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". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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 managable, 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). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments 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. Data type Resource
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWS. 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. Comments 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
issues	Σ C	0..1	OperationOutcome	There are no (further) constraints on this element Element id Bundle.issues Short description Issues with the Bundle Definition Captures issues and warnings that relate to the construction of the Bundle and the content within it. Comments Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle. Data type OperationOutcome Conditions The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

Bundle
Short	Contains a collection of resources
Definition	A container for a collection of resources.
Cardinality	0..*
Constraints	bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `(type = 'searchset') or entry.search.empty()` bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource `type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus)` bdl-14: entry.request.method PATCH not allowed for history `type = 'history' implies entry.request.method != 'PATCH'` bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated `type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST')` bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. `issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning')` bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. `type = 'document' implies issues.empty()` bdl-18: Self link is required for searchsets. `type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists()` bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements `type in ('document' \| 'message' \| 'searchset' \| 'collection') implies entry.all(resource.exists() and request.empty() and response.empty())` bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH `type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH `type in ('transaction' \| 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' \| 'PATCH' \| 'PUT')) = resource.exists()))` bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements `type in ('transaction-response' \| 'batch-response') implies entry.all(response.exists())`
Mappings	rim: Entity. Role, or Act,N/A w5: infrastructure.structure v2: N/A cda: ClinicalDocument, if bundle.type = document
Bundle.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.identifier
Short	Persistent identifier for the bundle
Definition	A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Cardinality	0..1
Type	Identifier
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-9
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier cda: ClinicalDocument.id
Bundle.identifier.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	id
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.identifier.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.identifier.use
Short	usual \| official \| temp \| secondary \| old (If known)
Definition	The purpose of this identifier.
Cardinality	0..1
Type	code
Binding	Identifies the purpose for this identifier, if known . IdentifierUse (required)
Modifier	True
Summary	True
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: N/A rim: Role.code or implied by context
Bundle.identifier.type
Short	Description of identifier
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality	0..1
Type	CodeableConcept
Binding	A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. IdentifierTypeCodes (extensible)
Summary	True
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.5 rim: Role.code or implied by context
Bundle.identifier.type.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	id
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.identifier.type.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value) Extensions are always sliced by (at least) url
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.identifier.type.coding
Short	Code defined by a terminology system
Definition	A reference to a code defined by a terminology system.
Cardinality	0..*
Type	Coding
Summary	True
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Bundle.identifier.type.text
Short	Plain text representation of the concept
Definition	A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality	1..1
Type	string
Summary	True
Requirements	The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments	Very often the text is the same as a displayName of one of the codings.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	Annual Calibration and Conductivity Probe Replaced
Mappings	v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Bundle.identifier.system
Short	The namespace for the identifier value
Definition	Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Cardinality	0..1
Type	uri
Summary	True
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.
Comments	Identifier.system is always case sensitive.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General http://www.acme.com/identifiers/patient
Mappings	v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
Bundle.identifier.value
Short	The value that is unique
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality	0..1
Type	string
Summary	True
Comments	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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.
Conditions	The cardinality or value of this element may be affected by these constraints: ident-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 123456
Mappings	v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
Bundle.identifier.period
Short	Time period when id is/was valid for use
Definition	Time period during which identifier is/was valid for use.
Cardinality	0..1
Type	Period
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
Bundle.identifier.assigner
Short	Organization that issued id (may be just text)
Definition	Organization that issued/manages the identifier.
Cardinality	0..1
Type	Reference(Organization)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
Bundle.type
Short	document \| message \| transaction \| transaction-response \| batch \| batch-response \| history \| searchset \| collection \| subscription-notification
Definition	Indicates the purpose of this bundle - how it is intended to be used.
Cardinality	1..1
Type	code
Binding	Indicates the purpose of a bundle - how it is intended to be used. BundleType (required)
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	collection
Mappings	w5: FiveWs.class
Bundle.timestamp
Short	When the bundle was assembled
Definition	The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Cardinality	0..1
Type	instant
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-10
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.init cda: ClinicalDocument.effectiveTime
Bundle.total
Short	If search, the total number of matches
Definition	If a set of search matches, this is the (potentially estimated) 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.
Cardinality	0..1
Type	unsignedInt
Summary	True
Comments	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.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-1
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link
Short	Links related to this Bundle
Definition	A series of links that provide context to this bundle.
Cardinality	0..*
Type	BackboneElement
Summary	True
Comments	Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.link.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.link.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.link.relation
Short	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-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.
Cardinality	1..1
Type	code
Binding	LinkRelationTypes (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.link.url
Short	Reference details for the link
Definition	The reference details for the link.
Cardinality	1..1
Type	uri
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-18
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry
Short	Entry in the bundle - will have a resource or information
Definition	An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Cardinality	0..*
Type	BackboneElement
Summary	True
Constraints	bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.exists() implies fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.link
Short	Links related to this entry
Definition	A series of links that provide context to this entry.
Cardinality	0..*
Type	see (link)
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.fullUrl
Short	URI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Definition	The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. 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. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when: invoking a create invoking or responding to an operation where the body is not a single identified resource invoking or returning the results of a search or history operation.
Cardinality	0..1
Type	uri
Summary	True
Comments	fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, 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, 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).
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-7, bdl-15, bdl-8
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource
Short	A resource in the bundle
Definition	The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.
Cardinality	0..1
Type	Resource
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
Bundle.entry.resource.id
Short	Logical id of this artifact
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0..1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Bundle.entry.resource.meta
Short	Metadata about the resource
Definition	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.
Cardinality	0..1
Type	Meta
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.implicitRules
Short	A set of rules under which this content was created
Definition	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.
Cardinality	0..1
Type	uri
Modifier	True
Summary	True
Comments	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 its narrative along with other profiles, value sets, etc.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.language
Short	Language of the resource content
Definition	The base language in which the resource is written.
Cardinality	0..1
Type	code
Binding	IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter)
Comments	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).
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.resource.resourceType
Pattern	Procedure \| Device
Bundle.entry.resource.Procedure
Bundle.entry.resource.Device
Bundle.entry.search
Short	Search related information
Definition	Information about the search process that lead to the creation of this entry.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-2
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.search.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.search.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.search.mode
Short	match \| include - why this is in the result set
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.
Cardinality	0..1
Type	code
Binding	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. SearchEntryMode (required)
Summary	True
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.search.score
Short	Search ranking (between 0 and 1)
Definition	When searching, the server's search ranking score for the entry.
Cardinality	0..1
Type	decimal
Summary	True
Comments	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 for the EMPI search which relates to this element.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request
Short	Additional execution information (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.request.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.request.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.request.method
Short	GET \| HEAD \| POST \| PUT \| DELETE \| PATCH
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.
Cardinality	1..1
Type	code
Binding	HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required)
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3b, bdl-3c, bdl-14, bdl-15
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.url
Short	URL for HTTP equivalent of this entry
Definition	The URL for this entry, relative to the root (the address to which the request is posted).
Cardinality	1..1
Type	uri
Summary	True
Comments	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]".
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneMatch
Short	For managing cache validation
Definition	If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifModifiedSince
Short	For managing cache currency
Definition	Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
Cardinality	0..1
Type	instant
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifMatch
Short	For managing update contention
Definition	Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.request.ifNoneExist
Short	For conditional creates
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". This is just the query portion of the URL - what follows the "?" (not including the "?").
Cardinality	0..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response
Short	Results of execution (transaction/batch/history)
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.
Cardinality	0..1
Type	BackboneElement
Summary	True
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-3a, bdl-3b, bdl-3d, bdl-5
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.id
Short	Unique id for inter-element referencing
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0..1
Type	string
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
Mappings	rim: n/a
Bundle.entry.response.extension
Short	Additional content defined by implementations
Definition	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 managable, 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.
Cardinality	0..*
Type	Extension
Alias	extensions, user content
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Bundle.entry.response.modifierExtension
Short	Extensions that cannot be ignored even if unrecognized
Definition	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 managable, 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).
Cardinality	0..*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Bundle.entry.response.status
Short	Status response code (text optional)
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.
Cardinality	1..1
Type	string
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.location
Short	The location (if the operation returns a location)
Definition	The location header created by processing this operation, populated if the operation returns a location.
Cardinality	0..1
Type	uri
Summary	True
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.etag
Short	The Etag for the resource (if relevant)
Definition	The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).
Cardinality	0..1
Type	string
Summary	True
Comments	Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.lastModified
Short	Server's date time modified
Definition	The date/time that the resource was modified on the server.
Cardinality	0..1
Type	instant
Summary	True
Comments	This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.entry.response.outcome
Short	OperationOutcome with hints and warnings (for batch/transaction)
Definition	An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.
Cardinality	0..1
Type	Resource
Summary	True
Comments	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.
Bundle.signature
Short	Digital Signature
Definition	Digital Signature - base64 encoded. XML-DSig or a JWS.
Cardinality	0..1
Type	Signature
Summary	True
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.
Comments	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.
Constraints	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Bundle.issues
Short	Issues with the Bundle
Definition	Captures issues and warnings that relate to the construction of the Bundle and the content within it.
Cardinality	0..1
Type	OperationOutcome
Summary	True
Comments	Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.
Conditions	The cardinality or value of this element may be affected by these constraints: bdl-16, bdl-17

<id value="AnnualCalibrationConductivityProbeReplaced" />
<url value="http://example.org/fhir/StructureDefinition/AnnualCalibrationConductivityProbeReplaced" />
<version value="1.0.0" />
<name value="AnnualCalibrationConductivityProbeReplaced" />
<title value="Annual Calibration and Conductivity Probe Replaced Profile" />
<status value="draft" />
<date value="2024-11-20" />
<description value="Profile for an annual calibration and conductivity probe replacement bundle." />
<fhirVersion value="5.0.0" />
<kind value="resource" />
<abstract value="false" />
<type value="Bundle" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle" />
<derivation value="constraint" />
<differential>
<element id="Bundle.identifier.type.text">
<path value="Bundle.identifier.type.text" />
<min value="1" />
<max value="1" />
<fixedString value="Annual Calibration and Conductivity Probe Replaced" />
</element>
<element id="Bundle.type">
<path value="Bundle.type" />
<min value="1" />
<max value="1" />
<fixedCode value="collection" />
</element>
<element id="Bundle.entry.resource.resourceType">
<path value="Bundle.entry.resource.resourceType" />
<patternCode value="Procedure | Device" />
</element>
<element id="Bundle.entry.resource.Procedure.status">
<path value="Bundle.entry.resource.Procedure.status" />
<min value="1" />
<max value="1" />
</element>
<element id="Bundle.entry.resource.Procedure.occurrenceDateTime">
<path value="Bundle.entry.resource.Procedure.occurrenceDateTime" />
<min value="1" />
<max value="1" />
</element>
<element id="Bundle.entry.resource.Procedure.outcome.text">
<path value="Bundle.entry.resource.Procedure.outcome.text" />
<min value="1" />
<max value="1" />
</element>
<element id="Bundle.entry.resource.Device.manufacturer">
<path value="Bundle.entry.resource.Device.manufacturer" />
<min value="1" />
<max value="1" />
</element>
<element id="Bundle.entry.resource.Device.serialNumber">
<path value="Bundle.entry.resource.Device.serialNumber" />
<min value="1" />
<max value="1" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "AnnualCalibrationConductivityProbeReplaced",
"url": "http://example.org/fhir/StructureDefinition/AnnualCalibrationConductivityProbeReplaced",
"version": "1.0.0",
"name": "AnnualCalibrationConductivityProbeReplaced",
"title": "Annual Calibration and Conductivity Probe Replaced Profile",
"status": "draft",
"date": "2024-11-20",
"description": "Profile for an annual calibration and conductivity probe replacement bundle.",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "Bundle",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Bundle",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Bundle.identifier.type.text",
"path": "Bundle.identifier.type.text",
"min": 1,
"max": "1",
"fixedString": "Annual Calibration and Conductivity Probe Replaced"
},
{
"id": "Bundle.type",
"path": "Bundle.type",
"min": 1,
"max": "1",
"fixedCode": "collection"
},
{
"id": "Bundle.entry.resource.resourceType",
"path": "Bundle.entry.resource.resourceType",
"patternCode": "Procedure | Device"
},
{
"id": "Bundle.entry.resource.Procedure.status",
"path": "Bundle.entry.resource.Procedure.status",
"min": 1,
"max": "1"
},
{
"id": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"path": "Bundle.entry.resource.Procedure.occurrenceDateTime",
"min": 1,
"max": "1"
},
{
"id": "Bundle.entry.resource.Procedure.outcome.text",
"path": "Bundle.entry.resource.Procedure.outcome.text",
"min": 1,
"max": "1"
},
{
"id": "Bundle.entry.resource.Device.manufacturer",
"path": "Bundle.entry.resource.Device.manufacturer",
"min": 1,
"max": "1"
},
{
"id": "Bundle.entry.resource.Device.serialNumber",
"path": "Bundle.entry.resource.Device.serialNumber",
"min": 1,
"max": "1"
}
]
}

}