Notification Request Service

This profile set is created and maintained by the LRA project. Implementers should treat this Implementation Guide as the source of truth for the LRA Notification Request profile definitions, terminology bindings, and message structure.

Overview

The LRA Notification Request Service provides a generic FHIR messaging pattern for submitting notification requests to LRA.

The service is designed to support multiple notification use cases over time. Each use case defines the business payload, applicable resource profiles, processing rules, and examples required for that specific notification scenario.

A Notification Request is submitted to the LRA notification endpoint using a FHIR Bundle of type message. The generic message structure includes a MessageHeader that provides the event, routing, source, destination, and message focus information.

The remaining Bundle entries are use-case-specific and are defined by the applicable notification use case. For example, the BC Cancer notification use case uses CommunicationRequest, DocumentReference, and Patient resources to represent the notification request, related document, and notification recipient.

Conformance

• The request SHALL be submitted as a FHIR R4 Bundle with Bundle.type = message.
• Bundle.identifier SHALL be used as the message-level unique identifier for tracking and correlation.
• The Bundle SHALL include a MessageHeader resource.
• MessageHeader SHALL be used for routing, event identification, source/destination context, and identifying the focus of the message.
• Use-case-specific payload resources SHALL be defined by the applicable notification use case.
• All resources included in the Bundle SHALL conform to the applicable LRA Notification Request profiles defined in this Implementation Guide.

Processing conventions

• The Notification Request Bundle is submitted to the LRA Notification endpoint using the $process-message operation.
• MessageHeader is used for routing and message context.
• The business payload is use-case-specific and may include request, recipient, document, or other supporting resources depending on the notification scenario.
• Each notification use case SHALL define:
  • the required payload resources;
  • the expected MessageHeader.event;
  • the expected MessageHeader.focus;
  • the applicable resource profiles;
  • use-case-specific business rules; and
  • example Bundles.

Interaction Guidance

The Notification Request interaction supports the submission of notification request messages from source systems to LRA.

Submit Notification Request

The system SHALL support submission of a Notification Request Bundle to the LRA notification endpoint.

POST [baseURL]/notification/$process-message

The submitted Bundle SHALL conform to the applicable LRA Notification Request profile for the notification use case being implemented.

Generic Request Bundle Structure

The generic Notification Request Bundle structure contains the following:

FHIR Resource	Cardinality	Purpose
MessageHeader	1..1	Identifies the notification event, source, destination, routing context, and focus of the message.
Use-case-specific payload resources	1..*	Represents the business payload required for a specific notification use case.

Use-case-specific resources are defined in the applicable use case section.

BC Cancer Notification Request Use Case

The BC Cancer Notification Request is one implementation of the generic LRA Notification Request Service.

In this use case, Health Gateway sends a Notification Request Bundle when a patient-facing notification should be sent for a BC Cancer document, such as a screening letter. The Bundle represents a single notification request and includes the message metadata, notification request, document reference, and patient recipient details.

BC Cancer Bundle Structure

The BC Cancer Notification Request Bundle contains the following resources:

FHIR Resource	Cardinality	Purpose
MessageHeader	1..1	Identifies the BC Cancer notification event and points to the primary request resource.
CommunicationRequest	1..1	Represents the request/order to notify the patient.
DocumentReference	1..1	Represents the BC Cancer document or letter that the notification is about.
Patient	1..1	Represents the patient/recipient of the notification.

BC Cancer Processing Rules

• The Bundle SHALL conform to the LRA Notification Request Bundle profile.
• MessageHeader.focus SHALL reference the CommunicationRequest.
• CommunicationRequest.subject and CommunicationRequest.recipient SHALL reference the Patient.
• CommunicationRequest.about SHALL reference the DocumentReference.
• If CommunicationRequest.medium includes SMSWRIT, the Patient SHALL include a phone number.
• If CommunicationRequest.medium includes EMAILWRIT, the Patient SHALL include an email address.
• DocumentReference represents the BC Cancer document or letter that the notification is about.

Example Bundle: Example Bundle - BC Cancer Notification Request

Profiles Content

The LRA Notification Request profiles define the FHIR message structure currently used to support the BC Cancer Notification Request use case. As additional notification use cases are introduced, this documentation may be expanded to describe additional payload resources, constraints, processing rules, and examples.

• Bundle

  The Bundle resource represents the complete Notification Request message submitted to LRA. The Bundle is constrained to type `message` and includes a message-level identifier used for tracking and correlation. For the BC Cancer notification use case, the Bundle contains the MessageHeader, CommunicationRequest, DocumentReference, and Patient resources required to process the notification request.

  LRANotificationRequestBundle (Bundle)	C		Bundle	Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints 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&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-3: entry.request mandatory for batch/transaction/history, otherwise prohibited entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history')) bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history')) bdl-12: A message must have a MessageHeader as the first resource type = 'message' implies entry.first().resource.is(MessageHeader) 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 entry.search.empty() or (type = 'searchset') bdl-11: A document must have a Composition as the first resource type = 'document' implies entry.first().resource.is(Composition) bdl-10: A document must have a date type = 'document' implies (timestamp.hasValue()) lra-notif-bdl-1: A notification request Bundle SHALL contain exactly one MessageHeader, one CommunicationRequest, one DocumentReference, and one Patient. entry.resource.ofType(MessageHeader).count() = 1 and entry.resource.ofType(CommunicationRequest).count() = 1 and entry.resource.ofType(DocumentReference).count() = 1 and entry.resource.ofType(Patient).count() = 1 Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
  id	Σ	0..1	string	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 The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  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 it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  identifier	S Σ	1..1	Identifier	Element id Bundle.identifier Short description Message-level unique identifier for correlation and tracking 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier cda: ClinicalDocument.id
  id		0..1	string	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 string 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a 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. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	S Σ	1..1	uriFixed Value	Element id Bundle.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value https://healthgateway.gov.bc.ca/identifiers/message-bundle Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	S Σ	1..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 Rendered Value extension. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a 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 C	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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	S Σ	1..1	codeBindingFixed Value	Element id Bundle.type Short description document | message | transaction | transaction-response | batch | batch-response | history | searchset | 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value message Mappings rim: n/a w5: FiveWs.class
  timestamp	S Σ	1..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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a 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 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: ele-1, bdl-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  link	Σ	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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  relation	Σ	1..1	string	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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  url	Σ	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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  entry	S Σ C	4..*	BackboneElement	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 Slicing Unordered, Open, by resource(Type) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() Mappings rim: n/a
  (All Slices)				The requirements in this element apply to all slices
  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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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.
  fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  resource	Σ	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. Data type Resource Mappings rim: Entity. Role, or Act
  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: ele-1, bdl-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 | outcome - 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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: ele-1, bdl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  method	Σ	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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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". Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 "?"). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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: ele-1, bdl-4 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  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 Mappings rim: Entity. Role, or Act
  messageHeader	S Σ C	1..1	BackboneElement	Element id Bundle.entry:messageHeader Short description Notification MessageHeader Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.link Short description Links related to this entry Definition A series of links that provide context to this entry.
  fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  resource	S Σ C	1..1	LRANotificationMessageHeader	Element id Bundle.entry:messageHeader.resource Short description A resource that describes a message that is exchanged between systems Definition The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Data type LRANotificationMessageHeader Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act v2: MSH / MSA / ERR rim: Message
  search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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: ele-1, bdl-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.search.mode Short description match | include | outcome - 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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: ele-1, bdl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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". Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 "?"). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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: ele-1, bdl-4 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry:messageHeader.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 Mappings rim: Entity. Role, or Act
  communicationRequest	S Σ C	1..1	BackboneElement	Element id Bundle.entry:communicationRequest Short description Notification CommunicationRequest Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.link Short description Links related to this entry Definition A series of links that provide context to this entry.
  fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  resource	S Σ C	1..1	LRANotificationCommunicationRequest	Element id Bundle.entry:communicationRequest.resource Short description A request for information to be sent to a receiver Definition A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition. Data type LRANotificationCommunicationRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Request
  search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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: ele-1, bdl-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.search.mode Short description match | include | outcome - 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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: ele-1, bdl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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". Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 "?"). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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: ele-1, bdl-4 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry:communicationRequest.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 Mappings rim: Entity. Role, or Act
  documentReference	S Σ C	1..1	BackboneElement	Element id Bundle.entry:documentReference Short description Notification DocumentReference Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:documentReference.link Short description Links related to this entry Definition A series of links that provide context to this entry.
  fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:documentReference.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  resource	S Σ C	1..1	LRANotificationDocumentReference	Element id Bundle.entry:documentReference.resource Short description A reference to a document Definition A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text. Comments Usually, this is used for documents other than those defined by FHIR. Data type LRANotificationDocumentReference Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event fhircomposition: when describing a Composition rim: Document[classCode="DOC" and moodCode="EVN"] cda: when describing a CDA
  search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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: ele-1, bdl-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:documentReference.search.mode Short description match | include | outcome - 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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: ele-1, bdl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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". Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 "?"). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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: ele-1, bdl-4 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry:documentReference.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 Mappings rim: Entity. Role, or Act
  patient	S Σ C	1..1	BackboneElement	Element id Bundle.entry:patient Short description Notification Patient Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:patient.link Short description Links related to this entry Definition A series of links that provide context to this entry.
  fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  resource	S Σ C	1..1	LRANotificationPatient	Element id Bundle.entry:patient.resource Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type LRANotificationPatient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() lra-notif-pt-1: Patient SHALL include at least one phone or email telecom. telecom.where(system = 'phone' or system = 'email').exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
  search	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.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: ele-1, bdl-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:patient.search.mode Short description match | include | outcome - 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  request	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.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: ele-1, bdl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:patient.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:patient.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". Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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". Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 "?"). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  response	Σ C	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.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: ele-1, bdl-4 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry:patient.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 Mappings rim: Entity. Role, or Act
  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 JWT. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A

• MessageHeader

  The MessageHeader resource captures key metadata about the Notification Request message, including the event type, source system, destination endpoint, and focus of the message. For the BC Cancer notification use case, the MessageHeader identifies the message as a BC Cancer notification request and points to the CommunicationRequest resource that represents the primary business request.

  LRANotificationMessageHeader (MessageHeader)	C		MessageHeader	There are no (further) constraints on this element Element id MessageHeader Short description A resource that describes a message that is exchanged between systems Definition The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Data type MessageHeader Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act v2: MSH / MSA / ERR rim: Message
  id	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.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 The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MessageHeader.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MessageHeader.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 it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id MessageHeader.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 A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id MessageHeader.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 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..*	Resource	There are no (further) constraints on this element Element id MessageHeader.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, and nor can they have their own independent transaction scope. 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 Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  event[x]	S Σ	1..1	Pattern	Element id MessageHeader.event[x] Short description Notification request event Definition Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition. Requirements Drives the behavior associated with this message. Comments The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp. Binding One of the message events defined as part of this version of FHIR. MessageEvent (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Pattern { "system": "http://phsa.ca/fhir/CodeSystem/notification-events", "code": "notification-request" } Mappings rim: n/a w5: FiveWs.what[x] v2: MSH-9.2 rim: ./payload[classCode="CACT" and moodCode="EVN" and isNormalAct()]/code[isNormalDatatype()]/code
  eventCoding			Coding	Data type Coding
  destination	S Σ	1..1	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.destination Short description Message destination application(s) Definition The destination application which the message is intended for. Requirements Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient". Comments There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.subject[x] rim: ./communicationFunction[typeCode="RCV"] w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.destination.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  name	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.destination.name Short description Name of system Definition Human-readable name for the target system. Requirements May be used for routing of response and/or to support audit. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-5 rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]/name[type='ST' and isNormalDatatype()])
  target	Σ C	0..1	Reference(Device)	There are no (further) constraints on this element Element id MessageHeader.destination.target Short description Particular delivery destination within the destination Definition Identifies the target end system in situations where the initial message transmission is to an intermediary system. Requirements Supports multi-hop routing. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]
  endpoint	S Σ	1..1	url	Element id MessageHeader.destination.endpoint Short description LRA notification $process-message endpoint Definition Indicates where the message should be routed to. Requirements Identifies where to route the message. Comments The id may be a non-resolvable URI for systems that do not use standard network-based addresses. Data type url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-25 (or MSH-6) rim: ./telecom
  receiver	Σ C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.destination.receiver Short description Intended "real-world" recipient for the data Definition Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient. Requirements Allows routing beyond just the application level. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  sender	Σ C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.sender Short description Real world sender of the message Definition Identifies the sending system to allow the use of a trust relationship. Requirements Allows routing beyond just the application level. Comments Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  enterer	Σ C	0..1	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.enterer Short description The source of the data entry Definition The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: EVN-5 / ORC-10 / PRT-5:PRT-4='EP' / ROL where ROL.3 is EP or ORC.10 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="ENT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  author	Σ C	0..1	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.author Short description The source of the decision Definition The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: ORC-19 / PRT-5:PRT-4='AUT' / ROL where ROL.3 is IP or ORC.12 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="AUT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  source	S Σ	1..1	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.source Short description Message source application Definition The source application from which this message originated. Requirements Allows replies, supports audit. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.actor rim: unique(./communicationFunction[typeCode="SND"])
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  name	S Σ	1..1	stringFixed Value	Element id MessageHeader.source.name Short description Source system code Definition Human-readable name for the source system. Requirements May be used to support audit. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value HGW Mappings rim: n/a v2: MSH-3 rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/name[type='ST' and isNormalDatatype()])
  software	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.software Short description Name of software running the system Definition May include configuration or other information useful in debugging. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-3 ( +SFT-1) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/softwareName[isNormalDatatype()])
  version	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.version Short description Version of software running Definition Can convey versions of multiple systems in situations where a message passes through multiple hands. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-2 rim: (Not supported)
  contact	Σ C	0..1	ContactPoint	There are no (further) constraints on this element Element id MessageHeader.source.contact Short description Human contact for problems Definition An e-mail, phone, website or other contact point to use to resolve issues with message communications. Requirements Allows escalation of technical issues. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: (MSH-22?) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/scopesRole[normalRole() and classCode="CON" and layer[classCode="PSN"]/telecom[isNormalDatatype()])
  endpoint	S Σ	1..1	urlFixed Value	Element id MessageHeader.source.endpoint Short description Actual message source address or id Definition Identifies the routing target to send acknowledgements to. Requirements Identifies where to send responses, may influence security permissions. Comments The id may be a non-resolvable URI for systems that do not use standard network-based addresses. Data type url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value https://www.healthgateway.gov.bc.ca/ Mappings rim: n/a v2: MSH-24 rim: ./telecom[isNormalDatatype()]
  responsible	Σ C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.responsible Short description Final responsibility for event Definition The person or organization that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.witness v2: ORC-12 / PRT-5:PRT-4='OP' / PRT-8:PRT-4='OP' / ROL where ROL.3 is RO or ORC.11 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode="PSN" and determinerCode="INST"] or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/scoper[isNormalEntity() and classCode="ORG" and determinerCode="INST"])
  reason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MessageHeader.reason Short description Cause of event Definition Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message. Requirements Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Reason for event occurrence. ExampleMessageReasonCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.why[x] v2: EVN.4 / ORC.16 / OBR-31-reason for study / BPO-13-BP indication for use / RXO-20-indication / RXE-27-give indication / RXD-21-indication / RXG-22-indication / RXA-19-indication rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/reasonCode[isNormalDatatype()])
  response	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.response Short description If this is a reply to prior message Definition Information about the message that this message is a response to. Only present if this message is a response. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA rim: ./conveyedAcknowledgement
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  identifier	Σ	1..1	id	There are no (further) constraints on this element Element id MessageHeader.response.identifier Short description Id of original message Definition The MessageHeader.id of the message to which this message is a response. Requirements Allows receiver to know what message is being responded to. Comments RFC 4122 Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA-2 rim: ./acknowledges.id[isNormalDatatype()]
  code	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id MessageHeader.response.code Short description ok | transient-error | fatal-error Definition Code that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not. Requirements Allows the sender of the acknowledge message to know if the request was successful or if action is needed. Comments This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus. Data type code Binding The kind of response to a message. ResponseType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA-1 rim: ./typeCode[isNormalDatatype()]
  details	Σ C	0..1	Reference(OperationOutcome)	There are no (further) constraints on this element Element id MessageHeader.response.details Short description Specific list of hints/warnings/errors Definition Full details of any issues found in the message. Requirements Allows the sender of the message to determine what the specific issues are. Comments This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error. Data type Reference(OperationOutcome) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: ERR rim: AcknowledgementDetail or Observation[classCode="ALRT" and moodCode="EVN"]
  focus	S Σ C	1..1	Reference(LRANotificationCommunicationRequest)	Element id MessageHeader.focus Short description Reference to the notification CommunicationRequest Definition The actual data of the message - a reference to the root/focus class of the event. Requirements Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources. Comments The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets. Data type Reference(LRANotificationCommunicationRequest) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="SUBJ" and isNormalParticipation]/role or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/outboundRelationship[typeCode="SBJ" and isNormalActRelatoinship]/target)
  definition	Σ	0..1	canonical(MessageDefinition)	There are no (further) constraints on this element Element id MessageHeader.definition Short description Link to the definition for this message Definition Permanent link to the MessageDefinition for this message. Requirements Allows sender to define the expected contents of the message. Comments see Canonical References Data type canonical(MessageDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: Not directly supported.

• CommunicationRequest

  The CommunicationRequest resource represents the notification order/request for the BC Cancer notification use case. It identifies the patient to be notified, the notification medium such as SMS and/or email, the notification type, the related document, and the request creation time. This is the primary business resource in the BC Cancer Notification Request Bundle.

  LRANotificationCommunicationRequest (CommunicationRequest)	C		CommunicationRequest	There are no (further) constraints on this element Element id CommunicationRequest Short description A request for information to be sent to a receiver Definition A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition. Data type CommunicationRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Request
  id	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.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 The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id CommunicationRequest.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id CommunicationRequest.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 it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id CommunicationRequest.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 A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id CommunicationRequest.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 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..*	Resource	There are no (further) constraints on this element Element id CommunicationRequest.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, and nor can they have their own independent transaction scope. 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 Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  identifier	S Σ	1..*	Identifier	Element id CommunicationRequest.identifier Short description Health Gateway order identifier Definition Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the communication request 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 a Person resource instance might share the same social insurance number. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.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 string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id CommunicationRequest.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a 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 CommunicationRequest.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. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	S Σ	1..1	uriFixed Value	Element id CommunicationRequest.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value https://healthgateway.gov.bc.ca/identifiers/order Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	S Σ	1..1	string	There are no (further) constraints on this element Element id CommunicationRequest.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 Rendered Value extension. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a 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 C	0..1	Period	There are no (further) constraints on this element Element id CommunicationRequest.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id CommunicationRequest.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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
  basedOn	Σ C	0..*	Reference(Resource)	There are no (further) constraints on this element Element id CommunicationRequest.basedOn Short description Fulfills plan or proposal Alternate names fulfills Definition A plan or proposal that is fulfilled in whole or in part by this request. Requirements Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[typeCode=FLFS].target
  replaces	Σ C	0..*	Reference(CommunicationRequest)	There are no (further) constraints on this element Element id CommunicationRequest.replaces Short description Request(s) replaced by this request Alternate names supersedes, prior Definition Completed or terminated request(s) whose function is taken by this new request. Requirements Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests. Comments The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing. Data type Reference(CommunicationRequest) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.replaces rim: .outboundRelationship[typeCode=RPLC].target
  groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id CommunicationRequest.groupIdentifier Short description Composite request this is part of Alternate names grouperId Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form. Comments Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.groupIdentifier rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier
  status	S Σ ?!	1..1	codeBindingFixed Value	Element id CommunicationRequest.status Short description draft | active | on-hold | revoked | completed | entered-in-error | unknown Definition The status of the proposal or order. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The status of the communication request. RequestStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value active Mappings rim: n/a workflow: Request.status w5: FiveWs.status
  statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id CommunicationRequest.statusReason Short description Reason for current status Alternate names Suspended Reason, Cancelled Reason Definition Captures the reason for the current state of the CommunicationRequest. Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings]. Data type CodeableConcept Binding Codes identifying the reason for the current state of a request. (unbound) (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
  category	S	1..1	CodeableConceptBinding	Element id CommunicationRequest.category Short description Notification type Definition The type of message to be sent such as alert, notification, reminder, instruction, etc. Comments There may be multiple axes of categorization and one communication request may serve multiple purposes. Data type CodeableConcept Binding Allowed notification type codes. LRANotificationType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.category.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.category.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  coding	S Σ	1..*	Coding	There are no (further) constraints on this element Element id CommunicationRequest.category.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  system	S Σ	1..1	uriFixed Value	Element id CommunicationRequest.category.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://phsa.ca/fhir/CodeSystem/notification-type Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	S Σ	1..1	code	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CommunicationRequest.category.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.category.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  priority	S Σ	1..1	codeBindingFixed Value	Element id CommunicationRequest.priority Short description routine | urgent | asap | stat Definition Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If missing, this task should be performed with normal priority Data type code Binding Codes indicating the relative importance of a communication request. RequestPriority (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value routine Mappings rim: n/a workflow: Request.priority w5: FiveWs.grade
  doNotPerform	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id CommunicationRequest.doNotPerform Short description True if request is prohibiting action Alternate names prohibited Definition If true indicates that the CommunicationRequest is asking for the specified action to not occur. Comments The attributes provided with the request qualify what is not to be done. Meaning when missing If do not perform is not specified, the request is a positive request e.g. "do perform" Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.doNotPerform
  medium	S	1..*	CodeableConceptBinding	Element id CommunicationRequest.medium Short description Notification channel: SMS and/or email Definition A channel that was used for this communication (e.g. email, fax). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Allowed notification media for LRA notification requests. LRANotificationMedium (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.medium.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.medium.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  coding	S Σ	1..*	Coding	There are no (further) constraints on this element Element id CommunicationRequest.medium.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  system	S Σ	1..1	uriFixed Value	Element id CommunicationRequest.medium.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://terminology.hl7.org/CodeSystem/v3-ParticipationMode Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	S Σ	1..1	code	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CommunicationRequest.medium.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.medium.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  subject	S C	1..1	Reference(LRANotificationPatient)	Element id CommunicationRequest.subject Short description Patient who is the subject of the notification request Alternate names patient Definition The patient or group that is the focus of this communication request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(LRANotificationPatient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject w5: FiveWs.subject[x] w5: FiveWs.subject
  about	S C	1..1	Reference(LRANotificationDocumentReference)	Element id CommunicationRequest.about Short description Document the notification is about Definition Other resources that pertain to this communication request and to which this communication request should be associated. Comments Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces. Data type Reference(LRANotificationDocumentReference) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context
  encounter	Σ C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id CommunicationRequest.encounter Short description Encounter created as part of Definition The Encounter during which this CommunicationRequest was created 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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.context w5: FiveWs.context
  payload		0..*	BackboneElement	There are no (further) constraints on this element Element id CommunicationRequest.payload Short description Message payload Definition Text, attachment(s), or resource(s) to be communicated to the recipient. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.payload.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.payload.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.payload.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  content[x]		1..1		There are no (further) constraints on this element Element id CommunicationRequest.payload.content[x] Short description Message part content Definition The communicated content (or for multi-part communications, one portion of the communication). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.note
  contentAttachment			Attachment	There are no (further) constraints on this element Data type Attachment
  contentReference			Reference(Resource)	There are no (further) constraints on this element Data type Reference(Resource)
  contentString			string	There are no (further) constraints on this element Data type string
  occurrence[x]	Σ	0..1		There are no (further) constraints on this element Element id CommunicationRequest.occurrence[x] Short description When scheduled Alternate names timing Definition The time when this communication is to occur. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.planned
  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
  authoredOn	S Σ	1..1	dateTime	Element id CommunicationRequest.authoredOn Short description Request creation timestamp Alternate names createdOn Definition For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.authoredOn w5: FiveWs.recorded
  requester	Σ C	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id CommunicationRequest.requester Short description Who/what is requesting service Alternate names author Definition The device, individual, or organization who initiated the request and has responsibility for its activation. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.requester w5: FiveWs.author rim: .participation[typeCode=AUT].role
  recipient	S C	1..*	Reference(LRANotificationPatient)	Element id CommunicationRequest.recipient Short description Patient notification recipient Definition The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(LRANotificationPatient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.performer w5: FiveWs.actor
  sender	S Σ C	1..1	Reference(Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	Element id CommunicationRequest.sender Short description System or organization sending the notification request Definition The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.performer w5: FiveWs.actor
  id		0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.sender.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CommunicationRequest.sender.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  reference	Σ C	0..1	string	There are no (further) constraints on this element Element id CommunicationRequest.sender.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id CommunicationRequest.sender.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id CommunicationRequest.sender.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	S Σ	1..1	stringFixed Value	Element id CommunicationRequest.sender.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value Health Gateway Mappings rim: n/a rim: N/A
  reasonCode	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id CommunicationRequest.reasonCode Short description Why is communication needed? Definition Describes why the request is being made in coded or textual form. Comments Textual reasons can be captured using reasonCode.text. Data type CodeableConcept Binding Codes for describing reasons for the occurrence of a communication. v3.ActReason (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode w5: FiveWs.why[x] rim: .reasonCode
  reasonReference	Σ C	0..*	Reference(Condition | DiagnosticReport | DocumentReference | Observation)	There are no (further) constraints on this element Element id CommunicationRequest.reasonReference Short description Why is communication needed? Definition Indicates another resource whose existence justifies this request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition | DiagnosticReport | DocumentReference | Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON].target
  note		0..*	Annotation	There are no (further) constraints on this element Element id CommunicationRequest.note Short description Comments made about communication request Definition Comments made about the request by the requester, sender, recipient, subject or other participants. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act workflow: Request.note rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]

• DocumentReference

  The DocumentReference resource represents the BC Cancer document or letter that the notification is about. It includes the document identifier, document type, patient subject, author/program display, custodian, and document URL where available. For this use case, the custodian may be represented as BC Cancer.

  LRANotificationDocumentReference (DocumentReference)	C		DocumentReference	There are no (further) constraints on this element Element id DocumentReference Short description A reference to a document Definition A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text. Comments Usually, this is used for documents other than those defined by FHIR. Data type DocumentReference Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event fhircomposition: when describing a Composition rim: Document[classCode="DOC" and moodCode="EVN"] cda: when describing a CDA
  id	Σ	0..1	string	There are no (further) constraints on this element Element id DocumentReference.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 The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id DocumentReference.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id DocumentReference.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 it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.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 A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id DocumentReference.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 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..*	Resource	There are no (further) constraints on this element Element id DocumentReference.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, and nor can they have their own independent transaction scope. 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 Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  masterIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id DocumentReference.masterIdentifier Short description Master Version Specific Identifier Definition Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document. Requirements The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.). Comments CDA Document Id extension and root. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier fhircomposition: Composition.identifier v2: TXA-12 rim: .id xds: DocumentEntry.uniqueId cda: ClinicalDocument/id
  identifier	S Σ	1..*	Identifier	Element id DocumentReference.identifier Short description Document identifier Definition Other identifiers associated with the document, including version independent identifiers. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier v2: TXA-16? rim: .id / .setId xds: DocumentEntry.entryUUID
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.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 string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a 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 DocumentReference.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. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	S Σ	1..1	uriFixed Value	Element id DocumentReference.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value https://healthgateway.gov.bc.ca/identifiers/document Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	S Σ	1..1	string	There are no (further) constraints on this element Element id DocumentReference.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 Rendered Value extension. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a 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 C	0..1	Period	There are no (further) constraints on this element Element id DocumentReference.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id DocumentReference.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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
  status	S Σ ?!	1..1	codeBindingFixed Value	Element id DocumentReference.status Short description current | superseded | entered-in-error Definition The status of this document reference. Comments This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid. Data type code Binding The status of the document reference. DocumentReferenceStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value current Mappings rim: n/a workflow: Event.status w5: FiveWs.status v2: TXA-19 rim: interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete" xds: DocumentEntry.availabilityStatus
  docStatus	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.docStatus Short description preliminary | final | amended | entered-in-error Definition The status of the underlying document. Comments The document that is pointed to might be in various lifecycle states. Data type code Binding Status of the underlying document. CompositionStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status fhircomposition: Composition.status v2: TXA-17 rim: .statusCode
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id DocumentReference.type Short description Kind of document (LOINC if possible) Definition Specifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced. Comments Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents. Data type CodeableConcept Binding Precise type of clinical document. DocumentTypeValueSet (preferred) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.class fhircomposition: Composition.type v2: TXA-2 rim: ./code xds: DocumentEntry.type cda: ClinicalDocument/code/@code The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.
  category	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id DocumentReference.category Short description Categorization of document Alternate names claxs Definition A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type. Comments Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching. Data type CodeableConcept Binding High-level kind of a clinical document at a macro level. DocumentClassValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class fhircomposition: Composition.class rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code xds: DocumentEntry.class cda: Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code
  subject	S Σ C	1..1	Reference(LRANotificationPatient)	Element id DocumentReference.subject Short description Patient who is the subject of the document Definition Who or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(LRANotificationPatient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] fhircomposition: Composition.subject v2: PID-3 (No standard way to define a Practitioner or Group subject in HL7 v2 MDM message) rim: .participation[typeCode="SBJ"].role[typeCode="PAT"] xds: DocumentEntry.patientId cda: ClinicalDocument/recordTarget/ w5: FiveWs.subject
  date	Σ	0..1	instant	There are no (further) constraints on this element Element id DocumentReference.date Short description When this document reference was created Alternate names indexed Definition When the document reference was created. Comments Referencing/indexing time is used for tracking, organizing versions and searching. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.recorded fhircomposition: Composition.date rim: .availabilityTime[type="TS"]
  author	S Σ C	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	Element id DocumentReference.author Short description Program responsible for the document Definition Identifies who is responsible for adding the information to the document. Comments Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant). Data type Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor fhircomposition: Composition.author v2: TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message) rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"] xds: DocumentEntry.author cda: ClinicalDocument/author
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.author.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.author.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  reference	Σ C	0..1	string	There are no (further) constraints on this element Element id DocumentReference.author.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id DocumentReference.author.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id DocumentReference.author.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	S Σ	1..1	string	Element id DocumentReference.author.display Short description Program name Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  authenticator	C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id DocumentReference.authenticator Short description Who/what authenticated the document Definition Which person or organization authenticates that this document is valid. Comments Represents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor w5: FiveWs.witness fhircomposition: Composition.attester v2: TXA-10 rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"] xds: DocumentEntry.legalAuthenticator cda: ClinicalDocument/legalAuthenticator
  custodian	S C	1..1	Reference(Organization)	There are no (further) constraints on this element Element id DocumentReference.custodian Short description Organization which maintains the document Definition Identifies the organization or group who is responsible for ongoing maintenance of and access to the document. Comments Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor fhircomposition: Composition.custodian rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.custodian.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.custodian.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  reference	Σ C	0..1	string	There are no (further) constraints on this element Element id DocumentReference.custodian.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id DocumentReference.custodian.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id DocumentReference.custodian.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	S Σ	1..1	stringFixed Value	Element id DocumentReference.custodian.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value BC Cancer Mappings rim: n/a rim: N/A
  relatesTo	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id DocumentReference.relatesTo Short description Relationships to other documents Definition Relationships that this document has with other document references that already exist. Comments This element is labeled as a modifier because documents that append to other documents are incomplete on their own. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a fhircomposition: Composition.relatesTo rim: .outboundRelationship xds: DocumentEntry Associations
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.relatesTo.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.relatesTo.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.relatesTo.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  code	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.relatesTo.code Short description replaces | transforms | signs | appends Definition The type of relationship that this document has with anther document. Comments If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. Data type code Binding The type of relationship between documents. DocumentRelationshipType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a fhircomposition: Composition.relatesTo.code rim: .outboundRelationship.typeCode xds: DocumentEntry Associations type
  target	Σ C	1..1	Reference(DocumentReference)	There are no (further) constraints on this element Element id DocumentReference.relatesTo.target Short description Target of the relationship Definition The target document of this relationship. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(DocumentReference) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) fhircomposition: Composition.relatesTo.target rim: .target[classCode="DOC", moodCode="EVN"].id xds: DocumentEntry Associations reference
  description	Σ	0..1	string	There are no (further) constraints on this element Element id DocumentReference.description Short description Human-readable description Definition Human-readable description of the source document. Requirements Helps humans to assess whether the document is of interest. Comments What the document is about, a terse summary of the document. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: TXA-25 rim: .outboundRelationship[typeCode="SUBJ"].target.text xds: DocumentEntry.comments
  securityLabel	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id DocumentReference.securityLabel Short description Document security-tags Definition A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to. Requirements Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended. Comments The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce. In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects. Data type CodeableConcept Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD fhircomposition: Composition.confidentiality, Composition.meta.security v2: TXA-18 rim: .confidentialityCode xds: DocumentEntry.confidentialityCode cda: ClinicalDocument/confidentialityCode/@code
  content	S Σ	1..*	BackboneElement	There are no (further) constraints on this element Element id DocumentReference.content Short description Document referenced Definition The document and format referenced. There may be multiple content element repetitions, each with a different format. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a fhircomposition: Bundle(Composition+*) rim: document.text
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.content.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.content.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.content.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  attachment	S Σ C	1..1	Attachment	There are no (further) constraints on this element Element id DocumentReference.content.attachment Short description Where to access the document Definition The document or URL of the document along with critical metadata to prove content has integrity. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent". Data type Attachment Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) att-1: If the Attachment has data, it SHALL have a contentType data.empty() or contentType.exists() Mappings rim: n/a v2: ED/RP rim: ED fhircomposition: Composition.language, Composition.title, Composition.date v2: TXA-3 for mime type rim: document.text xds: DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime cda: ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.content.attachment.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.content.attachment.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  contentType	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.content.attachment.contentType Short description Mime type of the content, with charset etc. Definition Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. Requirements Processors of the data need to be able to know how to interpret the data. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The mime type of an attachment. Any valid mime type is allowed. Mime Types (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General text/plain; charset=UTF-8, image/png Mappings rim: n/a v2: ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used rim: ./mediaType, ./charset
  language	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id DocumentReference.content.attachment.language Short description Human language of the content (BCP-47) Definition The human language of the content. The value can be any valid value according to BCP 47. Requirements Users need to be able to choose between the languages in a set of attachments. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General en-AU Mappings rim: n/a rim: ./language
  data		0..1	base64Binary	There are no (further) constraints on this element Element id DocumentReference.content.attachment.data Short description Data inline, base64ed Definition The actual data of the attachment - a sequence of bytes, base64 encoded. Requirements The data needs to able to be transmitted inline. Comments The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON. Data type base64Binary Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: ED.5 rim: ./data
  url	S Σ	1..1	url	Element id DocumentReference.content.attachment.url Short description Link to the document Definition A location where the data can be accessed. Requirements The data needs to be transmitted by reference. Comments If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. Data type url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/logo-small.png Mappings rim: n/a v2: RP.1+RP.2 - if they refer to a URL (see v2.6) rim: ./reference/literal
  size	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id DocumentReference.content.attachment.size Short description Number of bytes of content (if url provided) Definition The number of bytes of data that make up this attachment (before base64 encoding, if that is done). Requirements Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all. Comments The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A (needs data type R3 proposal)
  hash	Σ	0..1	base64Binary	There are no (further) constraints on this element Element id DocumentReference.content.attachment.hash Short description Hash of the data (sha-1, base64ed) Definition The calculated hash of the data using SHA-1. Represented using base64. Requirements Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version). Comments The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature. Data type base64Binary Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
  title	Σ	0..1	string	There are no (further) constraints on this element Element id DocumentReference.content.attachment.title Short description Label to display in place of the data Definition A label or set of text to display in place of the data. Requirements Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General Official Corporate Logo Mappings rim: n/a rim: ./title/data
  creation	Σ	0..1	dateTime	There are no (further) constraints on this element Element id DocumentReference.content.attachment.creation Short description Date attachment was first created Definition The date that the attachment was first created. Requirements This is often tracked as an integrity issue for use of the attachment. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A (needs data type R3 proposal)
  format	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id DocumentReference.content.format Short description Format/content rules for the document Definition An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType. Comments Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI. Data type Coding Binding Document Format Codes. DocumentReferenceFormatCodeSet (preferred) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding fhircomposition: Composition.meta.profile rim: document.text xds: DocumentEntry.formatCode cda: derived from the IHE Profile or Implementation Guide templateID
  context	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id DocumentReference.context Short description Clinical context of document Definition The clinical context in which the document was prepared. Comments These values are primarily added to help with searching for interesting/relevant documents. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
  id		0..1	string	There are no (further) constraints on this element Element id DocumentReference.context.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.context.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id DocumentReference.context.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  encounter	C	0..*	Reference(Encounter | EpisodeOfCare)	There are no (further) constraints on this element Element id DocumentReference.context.encounter Short description Context of the document content Definition Describes the clinical encounter or type of care that the document content is associated with. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Encounter | EpisodeOfCare) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context w5: FiveWs.context fhircomposition: Composition.encounter rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
  event		0..*	CodeableConcept	There are no (further) constraints on this element Element id DocumentReference.context.event Short description Main clinical acts documented Definition This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act. Comments An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation. Data type CodeableConcept Binding This list of codes represents the main clinical acts being documented. v3.ActCode (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD fhircomposition: Composition.event.code rim: .code xds: DocumentEntry.eventCodeList
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id DocumentReference.context.period Short description Time of service that is being documented Definition The time period over which the service that is described by the document was provided. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] fhircomposition: Composition.event.period rim: .effectiveTime xds: DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime cda: ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/low/ @value --> ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/high/ @value
  facilityType		0..1	CodeableConcept	There are no (further) constraints on this element Element id DocumentReference.context.facilityType Short description Kind of facility where patient was seen Definition The kind of facility where the patient was seen. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding XDS Facility Type. FacilityTypeCodeValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD fhircomposition: usually from a mapping to a local ValueSet rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code xds: DocumentEntry.healthcareFacilityTypeCode cda: usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code
  practiceSetting		0..1	CodeableConcept	There are no (further) constraints on this element Element id DocumentReference.context.practiceSetting Short description Additional details about where the content was created (e.g. clinical specialty) Definition This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty. Requirements This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content. Comments This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC. Data type CodeableConcept Binding Additional details about where the content was created (e.g. clinical specialty). PracticeSettingCodeValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD fhircomposition: usually from a mapping to a local ValueSet rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code xds: DocumentEntry.practiceSettingCode cda: usually from a mapping to a local ValueSet
  sourcePatientInfo	C	0..1	Reference(Patient)	There are no (further) constraints on this element Element id DocumentReference.context.sourcePatientInfo Short description Patient demographics from source Definition The Patient Information as known when the document was published. May be a reference to a version specific, or contained. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) fhircomposition: Composition.subject rim: .participation[typeCode="SBJ"].role[typeCode="PAT"] xds: DocumentEntry.sourcePatientInfo, DocumentEntry.sourcePatientId cda: ClinicalDocument/recordTarget/
  related	C	0..*	Reference(Resource)	There are no (further) constraints on this element Element id DocumentReference.context.related Short description Related identifiers or resources Definition Related identifiers or resources associated with the DocumentReference. Comments May be identifiers or resources that caused the DocumentReference or referenced Document to be created. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) fhircomposition: Composition.event.detail rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct] xds: DocumentEntry.referenceIdList cda: ClinicalDocument/relatedDocument

• Patient

  The Patient resource represents the recipient of the notification for the BC Cancer notification use case. It includes the patient identifier, including BC PHN where applicable, patient name, and contact details needed to support notification delivery by SMS and/or email.

  LRANotificationPatient (Patient)	C		Patient	Element id Patient Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() lra-notif-pt-1: Patient SHALL include at least one phone or email telecom. telecom.where(system = 'phone' or system = 'email').exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
  id	S Σ	1..1	string	Element id Patient.id Short description Source-assigned logical id for the patient Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.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 it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.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 A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.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 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.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, and nor can they have their own independent transaction scope. 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 Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  identifier	S Σ	1..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Slicing Unordered, Open, by system(Value) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
  phn	S Σ	1..1	Identifier	Element id Patient.identifier:phn Short description BC Personal Health Number Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
  id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:phn.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:phn.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:phn.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a 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 Patient.identifier:phn.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. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	S Σ	1..1	uriFixed Value	Element id Patient.identifier:phn.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.identifier:phn.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 Rendered Value extension. 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: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a 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 C	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:phn.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:phn.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) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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
  active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status rim: statusCode cda: n/a
  name	S Σ	1..*	HumanName	There are no (further) constraints on this element Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: PID-5, PID-9 rim: name cda: .patient.name
  id		0..1	string	There are no (further) constraints on this element Element id Patient.name.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual | official | temp | nickname | anonymous | old | maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data type code Binding The use of a human name. NameUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
  family	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
  given	S Σ	1..*	string	There are no (further) constraints on this element Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
  prefix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
  suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  telecom	S Σ C	1..*	ContactPoint	Element id Patient.telecom Short description Patient phone and/or email for notification Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
  id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  system	S Σ C	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.system Short description phone | fax | email | pager | url | sms | other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, cpt-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.3 rim: ./scheme servd: ./ContactPointType
  value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.telecom.value Short description The actual contact point details Definition The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.use Short description home | work | temp | old | mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Data type code Binding Use of contact point. ContactPointUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose
  rank	Σ	0..1	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: n/a
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  gender	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.gender Short description male | female | other | unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-8 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
  birthDate	Σ	0..1	date	There are no (further) constraints on this element Element id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). Data type date Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-7 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
  deceased[x]	Σ ?!	0..1		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
  deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
  deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
  address	Σ	0..*	Address	There are no (further) constraints on this element Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Patient may have multiple addresses with different uses or applicable periods. Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
  maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
  multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
  multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
  multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
  photo	C	0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) att-1: If the Attachment has data, it SHALL have a contentType data.empty() or contentType.exists() Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc cda: n/a
  contact	C	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) pat-1: SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists() Mappings rim: n/a rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: NK1-7, NK1-3 rim: code cda: n/a
  name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. Data type HumanName Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: NK1-2 rim: name cda: n/a
  telecom	C	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
  address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address v2: NK1-4 rim: addr cda: n/a
  gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male | female | other | unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: NK1-15 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
  organization	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, pat-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
  period	C	0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim: effectiveTime cda: n/a
  communication		0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: LanguageCommunication cda: patient.languageCommunication
  id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Binding extensions maxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-15, LAN-2 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
  preferred		0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-15 rim: preferenceInd cda: .preferenceInd
  generalPractitioner	C	0..*	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
  managingOrganization	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
  link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: outboundLink cda: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Patient.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 Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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 Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 rim: N/A
  other	Σ C	1..1	Reference(Patient | RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PID-3, MRG-1 rim: id cda: n/a
  type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by | replaces | refer | seealso Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: typeCode cda: n/a