• 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-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-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-10: A document must have a date
  type = 'document' implies (timestamp.hasValue())
• bdl-11: A document must have a Composition as the first resource
  type = 'document' implies entry.first().resource.is(Composition)
• bdl-12: A message must have a MessageHeader as the first resource
  type = 'message' implies entry.first().resource.is(MessageHeader)

• rim: Entity. Role, or Act
• v2: N/A
• rim: N/A
• cda: ClinicalDocument, if bundle.type = document

Unique GUID

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Use '2025.01.1' (It indicates FHIR changes on 2025-Jan).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

Updated: Relax the previously crossed-out elements.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunicationdistribution/Bundle'

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Bundle

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.identifier
• cda: ClinicalDocument.id

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: N/A
• rim: Role.code or implied by context

Allows users to make use of identifiers when the identifier system is not known.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: CX.5
• rim: Role.code or implied by context

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Allows for alternative encodings within a code system, and translations to other code systems.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1-8, C*E.10-22
• rim: union(., ./translation)
• orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

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.

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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
• source-panorama-ids: Panorama IDS Bundle ID

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.

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: CX.4 / EI-2-4
• rim: II.root or Role.id.root
• servd: ./IdentifierType
• source-panorama-ids: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-ids-source-gundle-id

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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
• source-panorama-ids: resourceBundle.id

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: CX.7 + CX.8
• rim: Role.effectiveTime or implied by context
• servd: ./StartDate and ./EndDate

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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

Hardcode as "collection" for distribution

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.class

Full dateTime with GMT offset, use local PIR timezone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.init
• cda: ClinicalDocument.effectiveTime

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• bdl-5: must be a resource unless there's a request or response
  resource.exists() or request.exists() or response.exists()
• bdl-8: fullUrl cannot be a version specific reference
  fullUrl.contains('/_history/').not()
• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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]".

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

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.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())