eEB

Implementierungsleitfaden elektronische Ersatzbescheinigung (eEB/GKV)

Die UseCases der elektronischen Ersatzbescheinigung digitalisieren den papierbasierten Prozess für Anwendungsfälle in der (Zahn-)Arztpraxis, in denen keine eGK als Versicherungsnachweis vorgelegt werden kann. Der bisherige papierbasierte Prozess für die Übermittlung von Ersatzbescheinigungen wie bspw. Fax, Papierausstellung usw. und der anschließenden händischen Übernahme der Daten sind langwierig, fehleranfällig und unkomfortabel für einen Großteil der Beteiligten.

Mit dem eEB-Verfahren wird die Anforderung und Ausstellung einer Ersatzbescheinigung für Versicherte der gesetzlichen Krankenkassen automatisierbar.

Mit Verabschiedung des DigiG am 02.02.2024 können die Versicherten gemäß §291 SGB V Absatz (9) einen Nachweis der Berechtigung zur Inanspruchnahme von Leistungen im Rahmen der vertragsärztlichen Versorgung von ihrer gesetzlichen Krankenkasse für die Vorlage bei einem Leistungserbringer anfordern, der unmittelbar von der Krankenkasse über ein sicheres Übermittlungsverfahren nach § 311 Absatz 6 (KIM) an den Leistungserbringer übermittelt wird.

Die Leistungserbringer stellen dazu den Versicherten ihre KIM-Adresse in maschinenlesbarer Form zur Verfügung (QR-Code-Scan), damit die Versicherten die KIM-Adresse mit der eEB-Beantragung ihrer Kasse übermitteln können.

Damit Versicherte, die nicht über die technischen Voraussetzungen verfügen, an diesem KIM-Verfahren teilnehmen zu können, können den Leistungserbringer bitten, die Anforderung zur Ausstellung einer elektronischen Ersatzbescheinigung via KIM durch das Praxispersonal zu initiieren. In diesem Fall kann ein Leistungserbringer für eine zu behandelnde Person, die keine Gesundheitskarte als Versicherungsnachweis vorlegen kann, eine Anfrage einer Ersatzbescheinigung bei der von der Person benannten oder bereits im System bekannten Krankenkasse erfolgen. Damit die Kasse die versicherte Person in ihrem Bestandssystem identifizieren kann, müssen der Anfrage ein Mindestsatz an personenbezogenen Daten der versicherten Person mitgegeben werden.

Hinweis zur Behandlung auf Basis einer Ersatzbescheinigung

Werden dem Patienten im Rahmen der Behandlung Medikamente verschrieben, muss der Einlöseweg eines E-Rezepts für den Patienten berücksichtigt werden. Ist die mitgeführte eGK nicht funktionsfähig, sollte dem Patienten der E-Rezept-Einlösecode als Ausdruck mitgegeben werden.

UseCase und Funktionsweise (Anforderung aus der Praxis)

Die Anforderung zur Ausstellung einer Ersatzbescheinigung für eine gesetzlich versicherte Person kann durch das Praxispersonal initiiert werden. Für die Anforderung einer Ersatzbescheinigung muss in der Praxis ein minimaler Satz an Informationen zur zu behandelnden Person erfasst und aus dem Praxisverwaltungssystem via KIM an die bekannte bzw. benannte Kasse als Anfrage gesendet werden. Die Kasse erstellt zur angefragten Person automatisiert, anhand der in ihrem Backend vorliegenden Versicherungsdaten einen FHIR-Datensatz, der dann via KIM der Praxis zugestellt wird.

Das Praxisverwaltungssystem kann die bereits erfassten bzw. vorhandenen Patientendaten mit den von der Kasse bereitgestellten Versichertenstammdaten aktualisieren.

gkv_ersatzverfahren

Erfassung personenbezogener Daten

Bei der Abfrage nach einer Ersatzbescheinigung zu einer Person sind zwei Fälle zu unterscheiden, ist die 10-stellige Versicherten-ID KVNR der Person bekannt oder unbekannt. Da diese KVNR für eine Person (i.d.R.) lebenslang gültig ist, ergibt sich die Antwort aus der Frage, ob der Patient in dieser Praxis in der Vergangenheit bereits vorstellig war.

Es hat sich bei Nutzung der KVNR als sinnvoll erwiesen, die KVNR vor Verwendung in der EEB-Anfrage ggf. einmal formal zu prüfen (Länge, Aufbau und Prüfziffer - siehe auch https://gkv-datenaustausch.de/kvnr/kvnr.jsp). Diese Hinweise helfen, Tippfehler zu vermeiden.

Patient ist im PVS bekannt

Um der Kasse Hilfe zum Auffinden der versicherten Person in ihrem Bestandssystem zu geben, müssen personenbezogene Informationen in einer FHIR-Ressource Patient mitgegeben werden. Ist die Person bereits im PVS als Patient hinterlegt (wurden bspw. in der Vergangenheit Behandlungen in der Praxis durchgeführt) können die Daten in einer Patienten-Ressource KBV_PR_FOR_Patient zusammengefasst werden, wie sie in anderen formularbasierten Anwendungen bereits genutzt wird. Es genügt auch der Eintrag der kvnr im identifier einer KnownPatient-Ressource. Weitere Angaben sind optional.

EEBKnownPatient (Patient)	I		Patient	There are no (further) constraints on this element 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-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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
id	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.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	1..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Patient.meta.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	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.meta.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id Patient.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id Patient.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
source	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
profile	Σ	1..1	canonical(StructureDefinition)Fixed Value	Element id Patient.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://gematik.de/fhir/eeb/StructureDefinition/EEBKnownPatient
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Patient.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments 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. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id Patient.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments 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. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id 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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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: N/A
extension	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	S Σ	1..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 Sliced: Unordered, Closed, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
versichertenId_GKV	Σ	0..1	IdentifierKvid10	Element id Patient.identifier:versichertenId_GKV Short description An identifier intended for computation Definition An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. Requirements Patients are almost always assigned specific numerical identifiers. Data type IdentifierKvid10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id 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
versichertenID_pkv	Σ	0..1		Element id Patient.identifier:versichertenID_pkv Short description An identifier intended for computation Definition An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. Requirements Patients are almost always assigned specific numerical identifiers. Data type Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id 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
active	Σ ?!	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name
telecom	Σ	0..0	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
gender	Σ	0..0	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
birthDate	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
deceased[x]	Σ ?!	0..0		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. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
address	Σ	0..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr
maritalStatus		0..0	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. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..0		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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
photo		0..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..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 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: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
communication		0..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication
generalPractitioner		0..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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
managingOrganization	Σ	0..0	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a

Patient ist im PVS unbekannt

Ist die zu behandelnde Person als Patient im PVS unbekannt, sind folgende Angaben mindestens erforderlich, um der Kasse eine Suche nach einem Versichertenverhältnis zu ermöglichen:

Der Familienname name
mindestens ein Vorname given
die Postleitzahl postalCode der Wohnaddress (Straßenname und Hausnummer sind nicht erforderlich) und
das birthDate

Diese Angaben sind in einer Patienten-Ressource KBV_PR_FOR_Patient einzutragen.

Es wird empfohlen, dass das Praxispersonal darauf hingewiesen wird, die versicherte Person nach der aktuellen Krankenkasse zu befragen und ggfs. die hinterlegte Krankenkasse für die Anfrage zu aktualisieren.

Angaben zur anfragenden Praxis

Die Kasse benötigt für die Ausstellung einer Ersatzbescheinigung Informationen über die anfragende Praxis, um das Ausstellen von "Blanko"-Bescheinigungen zu unterbinden. Dazu muss jeder Anfrage eine FHIR-Ressource Organization des Profils KBV_PR_FOR_Organization mitgegeben werden. Die Anfrage muss entweder die Betriebsstättennummer BSNR, die KZV Abrechnungsnummer KZVA, Standortnummer des Krankenhauses oder das Institutionskennzeichen enthalten, um die anfragende Praxis zu identifizieren, zusätzlich kann die TelematikID angegeben werden. Ebenso müssen die Angaben zur address und telecom-Kontaktinformationen für Rückfragen angegeben sein.

Signatur der Anfrage

Die Anfrage (das FHIR-Bundle) muss mittels der Institutionsidentität (SMC-B OSIG) signiert werden, um der angefragten Kasse einen Authentizitäts-Nachweis bereitzustellen. Die Signatur der KIM-Nachricht reicht dabei nicht aus, da diese nur die Integrität des Transports und Authentizität des KIM-Absenders sicherstellt, aber nicht, ob der Absender auch tatsächlich die Institution ist, gegenüber der der Patient eingewilligt hat. Daher ist der FHIR-Datensatz als Base64-Codierter PKCS#7-Container bereitzustellen (enveloping Signatur) in die KIM-Anfrage einzubetten.

Mittels der Konnektoroperation signDocument wird die Signatur erstellt.

<?xml version="1.0" encoding="utf-8"?>
<SOAP-ENV:Envelope xmlns:SOAP-ENV="http://schemas.xmlsoap.org/soap/envelope/"
    xmlns:SOAP-ENC="http://schemas.xmlsoap.org/soap/encoding/"
    xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
    xmlns:xsd="http://www.w3.org/2001/XMLSchema"
    xmlns:m0="http://ws.gematik.de/conn/ConnectorCommon/v5.0"
    xmlns:m1="http://ws.gematik.de/conn/ConnectorContext/v2.0"
    xmlns:m2="urn:oasis:names:tc:dss:1.0:core:schema"
    xmlns:m3="http://www.w3.org/2000/09/xmldsig#"
    xmlns:m4="urn:oasis:names:tc:dss-x:1.0:profiles:SignaturePolicy:schema#">
    <SOAP-ENV:Body>
        <m:SignDocument xmlns:m="http://ws.gematik.de/conn/SignatureService/v7.4">
            <m0:CardHandle>SMCB1</m0:CardHandle>
            <m1:Context>
                <m0:MandantId>Mandant1</m0:MandantId>
                <m0:ClientSystemId>ClientID1</m0:ClientSystemId>
                <m0:WorkplaceId>Tisch2</m0:WorkplaceId>
                <m0:UserId>4711</m0:UserId>
            </m1:Context>
            <m:TvMode>NONE</m:TvMode>
            <m:JobNumber>MMD-636</m:JobNumber>
            <m:SignRequest RequestID="Doc1">
                <m:OptionalInputs>
                    <m2:SignatureType>urn:ietf:rfc:5652</m2:SignatureType>
                    <m:IncludeEContent>true</m:IncludeEContent>
                </m:OptionalInputs>
                <m:Document ID="CMS-Doc1" ShortText="eEB-Anfrage">
                    <m2:Base64Data MimeType="text/plain; charset=utf-8">PEJ1bmRsZSB4bWxucz0iaHR0cDovL2hsNy5vcmcvZmhpciI
                    +CiAgICA8aWQgdmFsdWU9IjFmMzExYzQwLWZlZTktNGIwMy1iMGM0LWMyOWQ0MzJmMjM3MSIgLz4K
                    ICAgIDxtZXRhPgogICAgICAgIDwhLS0gZWluIHN0YXJrIGdla/xyenRlcyBCZWlzcGllbCAtLT4KI
                    CAgIDwvbWV0YT4KICAgIDxpZGVudGlmaWVyPgogICAgICAgIDxzeXN0ZW0gdmFsdWU9InVybjppZX
                    RmOnJmYzozOTg2IiAvPgogICAgICAgIDx2YWx1ZSB2YWx1ZT0idXJuOnV1aWQ6Nzk5MzllMzQtYzV
                    jYy00ZGE2LWJhNTUtZjRiZDg1ODMyNzYwIiAvPgogICAgPC9pZGVudGlmaWVyPgogICAgPHRpbWVz
                    dGFtcCB2YWx1ZT0iMjAyMi0wOC0yOVQwMjoxMDozNy4xNTQrMDI6MDAiIC8+CjwvQnVuZGxlPg==</m2:Base64Data>
                </m:Document>
                <m:IncludeRevocationInfo>true</m:IncludeRevocationInfo>
            </m:SignRequest>
        </m:SignDocument>
    </SOAP-ENV:Body>
</SOAP-ENV:Envelope>

Hinweis: Der ShortText darf nicht länger als 30 Zeichen sein.

Im Ergebnis liefert der Konnektor eine SignDocumentResponse, die anschließend in die zu verschickende KIM-Anfrage eingebettet wird.

<SOAP-ENV:Envelope
    xmlns:SOAP-ENV="http://schemas.xmlsoap.org/soap/envelope/">
    <SOAP-ENV:Header/>
    <SOAP-ENV:Body>
        <ns8:SignDocumentResponse
            xmlns:ns10="urn:oasis:names:tc:dss-x:1.0:profiles:verificationreport:schema#"
            xmlns:ns11="http://uri.etsi.org/01903/v1.3.2#"
            xmlns:ns12="http://uri.etsi.org/02231/v2#"
            xmlns:ns2="http://ws.gematik.de/conn/EncryptionService/v6.1"
            xmlns:ns3="http://ws.gematik.de/conn/ConnectorCommon/v5.0"
            xmlns:ns4="http://ws.gematik.de/conn/ConnectorContext/v2.0"
            xmlns:ns5="urn:oasis:names:tc:dss:1.0:core:schema"
            xmlns:ns6="http://www.w3.org/2000/09/xmldsig#"
            xmlns:ns7="http://ws.gematik.de/tel/error/v2.0"
            xmlns:ns8="http://ws.gematik.de/conn/SignatureService/v7.4"
            xmlns:ns9="urn:oasis:names:tc:dss-x:1.0:profiles:SignaturePolicy:schema#">
            <ns8:SignResponse RequestID="Doc1">
                <ns3:Status>
                    <ns3:Result>OK</ns3:Result>
                </ns3:Status>
                <ns8:OptionalOutputs>
                    <ns8:DocumentWithSignature ID="CMS-Doc1" ShortText="eEB-Anfrage">
                        <ns5:Base64Data MimeType="text/plain; charset=utf-8"/>
                    </ns8:DocumentWithSignature>
                </ns8:OptionalOutputs>
                <ns5:SignatureObject>
                    <ns5:Base64Signature Type="urn:ietf:rfc:5652">TG9yZW0gSW1zcHVtIQpJIGFtIGEgQ0FkRVMgZW52ZWxvcGluZyBzaWdudGF0dXJlIG9mIGEgZUVCL
                    UFuZnJhZ2UgRkhJUi1CdW5kbGUgaW4gWE1MIHJlcHJlc2VudGF0aW9uLg==</ns5:Base64Signature>
                </ns5:SignatureObject>
            </ns8:SignResponse>
        </ns8:SignDocumentResponse>
    </SOAP-ENV:Body>
</SOAP-ENV:Envelope>

KIM-Empfängeradresse der Krankenkasse

Die Suche nach der KIM-Empfängeradresse der Kasse erfolgt im zentralen Verzeichnisdienst VZD. Folgendes Beispiel für einen Konsolenaufruf mittels ldapsearch im VZD der TI-Referenzumgebung RU mit der Suche nach einer Krankenkasse OID=1.2.276.0.76.4.59 und Teil des Namens Techniker in einem kombinierten LDAP-Filter (&(professionOID=1.2.276.0.76.4.59)(displayName=Techniker*)):

ldapsearch  -x -H ldaps://10.24.11.11:1636  -b dc=data,dc=vzd  "(&(professionOID=1.2.276.0.76.4.59)(displayName=Techniker*))"

Zur Vereinfachung der Praxisabläufe sollte die Suche ins Praxisverwaltungssystem integriert werden. Bei bekannten Patienten kann die KIM-Adresse aus dem Verzeichnisdienst über den Filter des Haupt-IK (gemäß er Kostenträgerstammdatei) der Krankenkasse abgefragt werden (XML-Element ./kostentraeger/ik_liste/ik@V).

Hier der Einfachheit halber ebenfalls als Konsolenaufruf:

ldapsearch  -x -H ldaps://10.24.11.11:1636  -b dc=data,dc=vzd  "(&(domainID=101577501)(entryType=5))"

Diese liefert folgendes Ergebnis

# extended LDIF

#

# LDAPv3

# base <dc=data,dc=vzd> with scope subtree

# filter: (&(domainID=101577501)(entryType=5))

# requesting: ALL

#

# fc695fd6-b6e9-4754-9684-fee70f743086, data.vzd

dn: uid=fc695fd6-b6e9-4754-9684-fee70f743086,dc=data,dc=vzd
objectClass: vzd-komleview
objectClass: top
mail: tk-intern@akquinet.kim.telematik-test
mail: tk-dt03@akquinet.kim.telematik-test
mail: tk-dt01@akquinet.kim.telematik-test
mail: tk-dt02@akquinet.kim.telematik-test
mail: tk-dein@akquinet.kim.telematik-test
otherName: -
displayName: Techniker Krankenkasse
cn: Techniker Krankenkasse
organization: Techniker Krankenkasse NOT-VALID
userCertificate;binary:: MIIFQzCCBCugAwIBAgICBWIwDQYJKoZIhvcNAQELBQAwgbYxCzAJB
gNVBAYTAkRFMTowOAYDVQQKDDFULVN5c3RlbXMgSW50ZXJuYXRpb25hbCBHbWJIIC0gRzIgTG9zID
MgTk9ULVZBTElEMUgwRgYDVQQLDD9JbnN0aXR1dGlvbiBkZXMgR2VzdW5kaGVpdHN3ZXNlbnMtQ0E
gZGVyIFRlbGVtYXRpa2luZnJhc3RydWt0dXIxITAfBgNVBAMMGFRTWVNJLlNNQ0ItQ0EzIFRFU1Qt
T05MWTAeFw0yMTA3MTIwNzUzMTJaFw0yNjA3MTIyMzU5NTlaMIHFMQswCQYDVQQGEwJERTEQMA4GA
1UEBwwHSGFtYnVyZzEOMAwGA1UEEQwFMjIzMDUxHDAaBgNVBAkME0JyYW1mZWxkZXIgU3RyLiAxND
AxKTAnBgNVBAoMIFRlY2huaWtlciBLcmFua2Vua2Fzc2UgTk9ULVZBTElEMSAwHgYDVQQFExcxMi4
4MDI3NjAwMzQ0MTIwMDA3NTA4NTEpMCcGA1UEAwwgVGVjaG5pa2VyIEtyYW5rZW5rYXNzZSBURVNU
LU9OTFkwggEiMA0GCSqGSIb3DQEBAQUAA4IBDwAwggEKAoIBAQCFAAwf1Xov5A8x4079MacZm3wb4
DFN2c0ugwZdvTZLWacLHWfWOUi4Ct06rxuSgsEcyX4P0uU/IDul+BDhpE3hjhV26eoQzHfbNbUl0O
DTSnWhBqEzjnG3bj4FNqK3rWkeZNmeR1mTp3PjtpPJ4mjGKDDXpNzj+2zhVLe54NI+G2HIllb0tWa
lmq/kmdQTafPTHjD6nhcKX7Di51/mLebNW8+xiWr3087RfsguxOpELdRzgsE4jYJ3nUNZSKZv3JIU
TsYwvhrg50gjPLh1XEelv4dcjJWDj0whmo1qEOKEw0AKnnKXnGRWNzFprVxR2Y0wyG5AG+QeSSiM1
mqVrvgHAgMBAAGjggFIMIIBRDAdBgNVHQ4EFgQUIamKsyVjeh+/jROwwH6/W8lQw5QwDgYDVR0PAQ
H/BAQDAgQwMAwGA1UdEwEB/wQCMAAwIAYDVR0gBBkwFzAKBggqghQATASBIzAJBgcqghQATARMMEI
GCCsGAQUFBwEBBDYwNDAyBggrBgEFBQcwAYYmaHR0cDovL29jc3Auc21jYi50ZXN0LnRlbGVzZWMu
ZGUvb2NzcHIwHwYDVR0jBBgwFoAUMz3U691kvP0AL8E2m1wVWEUrriwwfgYFKyQIAwMEdTBzpCwwK
jELMAkGA1UEBhMCREUxGzAZBgNVBAoMElNNLUIgS1RSIFN1YmRvbWFpbjBDMEEwPzA9MB8MHUJldH
JpZWJzc3TDpHR0ZSBLb3N0ZW50csOkZ2VyMAkGByqCFABMBDsTDzgtMDEtMDAwMDAwMDA5MDANBgk
qhkiG9w0BAQsFAAOCAQEAFgX+0xMfQujIxwpTk/oAOqEJ40LckYsCxs1nJPJlfo3xLdvwu7ADlnYQ
Zpv89/j+VVjsntSUknOQ508P6N1WsvEwW1knLTloCIUY8g0cAtbPFMjo9cJwuCFbip2vWJxUXVuFk
x4vTqMw24N+aXzfOoO1EYTusuvRasG3pdjzjBeGvMtWPjjPuXiSyHbyVn3zn3FkIP8ss4z7iLPLDM
gIm1MHwWVE5u/s1eKWgYm6H6O0D/3uwTAXA+sbTCGCW2CAizAqzCinZAgaFWslCMbSFxef2gUuFsp
OmpvYt4gnT3iQ6I5aSO5wSYKL/t1vsk8q5YTXmxFS641CIfM9RimalQ==
userCertificate;binary:: MIIDuTCCA2CgAwIBAgICAN8wCgYIKoZIzj0EAwIwgbgxCzAJBgNVB
AYTAkRFMTwwOgYDVQQKDDNEZXV0c2NoZSBUZWxla29tIFNlY3VyaXR5IEdtYkggLSBHMiBMb3MgMy
BOT1QtVkFMSUQxSDBGBgNVBAsMP0luc3RpdHV0aW9uIGRlcyBHZXN1bmRoZWl0c3dlc2Vucy1DQSB
kZXIgVGVsZW1hdGlraW5mcmFzdHJ1a3R1cjEhMB8GA1UEAwwYVFNZU0kuU01DQi1DQTQgVEVTVC1P
TkxZMB4XDTIxMDcxMjA3NTMxMloXDTI2MDcxMjIzNTk1OVowgcUxCzAJBgNVBAYTAkRFMRAwDgYDV
QQHDAdIYW1idXJnMQ4wDAYDVQQRDAUyMjMwNTEcMBoGA1UECQwTQnJhbWZlbGRlciBTdHIuIDE0MD
EpMCcGA1UECgwgVGVjaG5pa2VyIEtyYW5rZW5rYXNzZSBOT1QtVkFMSUQxIDAeBgNVBAUTFzEyLjg
wMjc2MDAzNDQxMjAwMDc1MDg1MSkwJwYDVQQDDCBUZWNobmlrZXIgS3Jhbmtlbmthc3NlIFRFU1Qt
T05MWTBaMBQGByqGSM49AgEGCSskAwMCCAEBBwNCAASJVInVJ+T7m9Cb15TnGktiMH0S7u2hySspy
3JDMp4IqEx0CtwRxlVdXQDAga+Cpy4p445yDtRKdM61ZHO14Mt3o4IBSDCCAUQwHQYDVR0OBBYEFK
PYQvWf9gVo9c1pHtbrTkMDdat5MA4GA1UdDwEB/wQEAwIDCDAMBgNVHRMBAf8EAjAAMCAGA1UdIAQ
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dHA6Ly9vY3NwLnNtY2IudGVzdC50ZWxlc2VjLmRlL29jc3ByMB8GA1UdIwQYMBaAFDOvpKthm/Vi6
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tUUiBTdWJkb21haW4wQzBBMD8wPTAfDB1CZXRyaWVic3N0w6R0dGUgS29zdGVudHLDpGdlcjAJBgc
qghQATAQ7Ew84LTAxLTAwMDAwMDAwOTAwCgYIKoZIzj0EAwIDRwAwRAIgb0N3jrN1ylNYC8hlb26l
8EGsw0Vv5Ne5T1FR1JRIloYCIEpvsMlUGxVwGMj+fh/9blAcpWcNga8RhcbvjPLp80PY
personalEntry: false
title: -
KOM-LE-Version: 1.0
domainID: 101577501
entryType: 5
telematikID: 8-01-0000000090
dataFromAuthority: TRUE
countryCode: DE
street: Bramfelder Str. 140
holder: dtsg
professionOID: 1.2.276.0.76.4.59
komLeData: 1.0,tk-dt03@akquinet.kim.telematik-test
komLeData: 1.0,tk-intern@akquinet.kim.telematik-test
komLeData: 1.0,tk-dt01@akquinet.kim.telematik-test
komLeData: 1.0,tk-dt02@akquinet.kim.telematik-test
komLeData: 1.0,tk-dein@akquinet.kim.telematik-test
st: -
l: Hamburg
postalCode: 22305
changeDateTime: 2021-10-12T10:45:25.537594+02:00
uid: fc695fd6-b6e9-4754-9684-fee70f743086

# search result

search: 2
result: 0 Success

# numResponses: 2

# numEntries: 1

Im Attribut komLeData steht die zu verwendende KIM-Adresse hier komLeData: 1.0,tk-dt03@akquinet.kim.telematik-test.

Sollten zu dem ausgewählten Kostenträger mehrere Verzeichniseinträge hinterlegt sein (in der PU - Produktivumgebung - kann das aktuell jedoch nicht vorkommen), dann sollte geprüft werden, für welchen dieser Verzeichniseinträge eine KIM-Adresse hinterlegt ist. Sind mehrere KIM-Adressen hinterlegt - auch dieser Fall ist aktuell in der PU nicht vorgesehen, empfiehlt sich der Versand an die erste gefundene KIM-Adresse der jeweiligen Krankenkasse.

Kann kein Empfänger aus dem VZD der TI ermittelt werden, muss der Anwendungsfall mit einer Fehlermeldung abgebrochen werden, demzufolge die Empfängeradresse der Krankenkasse mit den bereitgestellten Informationen nicht ermittelt werden konnte. Ggfs. müssen die Angaben durch den Patienten konkretisiert werden, bei welcher Krankenkasse er versichert ist.

Hinweis

Im obigen Beispiel sind 5 KIM-Adressen im VZD-Eintrag enthalten. Gängige E-Mail-Clients mit LDAP-Integration verwenden die erste gefundene Adresse. Der VZD-Eintrag der Techniker Krankenkasse enthält in der Produktiv-Umgebung genau eine KIM-Adresse.

Details und weitere Hinweise zur Suche finden sich in der API-Beschreibung zum VZD.

Anforderung zur Ausstellung einer Ersatzbescheinigung via KIM

Liegen alle Informationen im PVS vor, werden diese in einer FHIR-Ressource EEBAnfrageBundle zusammengestellt und als Anhang einer KIM-Nachricht an die Kasse gesendet.

Anfrage Header

Der für den genutzten Bundle-Typ message verpflichtende Header transportiert neben Metainformationen (Leistungsdatum, Referenz auf die anfragende Praxis KBV_PR_FOR_Organization) das Einverständnis des Patienten (true = eingewilligt), das zuvor vom Praxispersonal eingeholt wurde. Das Feld MessageHeader.source.endpoint ist dabei ein vom FHIR-Standard vorgesehenes Pflichtfeld, das mit einer vom PVS gewählten URL belegt werden kann.

EEBAnfrageHeader (MessageHeader)	I		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-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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() 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	1..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.meta.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	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.meta.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id MessageHeader.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id MessageHeader.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
source	Σ	0..1	uri	There are no (further) constraints on this element Element id MessageHeader.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
profile	Σ	1..1	canonical(StructureDefinition)Fixed Value	Element id MessageHeader.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://gematik.de/fhir/eeb/StructureDefinition/EEBAnfrageHeader
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id MessageHeader.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments 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. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id MessageHeader.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments 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. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id 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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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: N/A
extension	I	3..*	Extension	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 Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
Leistungsdatum	I	1..1	Extension(date)	Element id MessageHeader.extension:Leistungsdatum Short description Datum der Leistungserbringung Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(date) Extension URL https://gematik.de/fhir/eeb/StructureDefinition/Leistungsdatum Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.extension:Leistungsdatum.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	I	0..0	Extension	There are no (further) constraints on this element Element id MessageHeader.extension:Leistungsdatum.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MessageHeader.extension:Leistungsdatum.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/eeb/StructureDefinition/Leistungsdatum Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id MessageHeader.extension:Leistungsdatum.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueDate			date	There are no (further) constraints on this element Data type date
Einverstaendnis	I	1..1	Extension(boolean)	Element id MessageHeader.extension:Einverstaendnis Short description Einverständnis des Versicherten Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(boolean) Extension URL https://gematik.de/fhir/eeb/StructureDefinition/Einverstaendnis Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.extension:Einverstaendnis.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	I	0..0	Extension	There are no (further) constraints on this element Element id MessageHeader.extension:Einverstaendnis.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MessageHeader.extension:Einverstaendnis.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/eeb/StructureDefinition/Einverstaendnis Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id MessageHeader.extension:Einverstaendnis.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
Institutionskennzeichen	I	1..1	Extension(IdentifierIknr)	Element id MessageHeader.extension:Institutionskennzeichen Short description Institutionskennzeichen der Krankenkasse Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(IdentifierIknr) Extension URL https://gematik.de/fhir/eeb/StructureDefinition/Institutionskennzeichen Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.extension:Institutionskennzeichen.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	I	0..0	Extension	There are no (further) constraints on this element Element id MessageHeader.extension:Institutionskennzeichen.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MessageHeader.extension:Institutionskennzeichen.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/eeb/StructureDefinition/Institutionskennzeichen Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id MessageHeader.extension:Institutionskennzeichen.value[x] Short description An identifier intended for computation Definition An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. 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 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
valueIdentifier			IdentifierIknr	There are no (further) constraints on this element Data type IdentifierIknr
modifierExtension	?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
event[x]	Σ	1..1	Binding	Element id MessageHeader.event[x] Short description Code for the event this message represents or link to event definition 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. EEBAnfrageUrsprungVS (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.subject[x] rim: ./communicationFunction[typeCode="RCV"] w5: FiveWs.subject
sender	Σ	1..1	Reference()	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() Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.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	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	Σ I	1..1	string	There are no (further) constraints on this element Element id MessageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id MessageHeader.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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id MessageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
enterer	Σ	0..0	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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	0..0	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
name	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.source.name Short description Name of system Definition Human-readable name for the source system. Requirements May be used to support audit. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: MSH-3 rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/name[type='ST' and isNormalDatatype()])
software	Σ	0..0	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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SFT-3 ( +SFT-1) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/softwareName[isNormalDatatype()])
version	Σ	0..0	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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SFT-2 rim: (Not supported)
contact	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (MSH-22?) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/scopesRole[normalRole() and classCode="CON" and layer[classCode="PSN"]/telecom[isNormalDatatype()])
endpoint	Σ	1..1	url	Element id MessageHeader.source.endpoint Short description Source endpoint URI of sender. E.g. https://pvs.de/KIM 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: MSH-24 rim: ./telecom[isNormalDatatype()]
responsible	Σ	0..0	Reference(Practitioner \| PractitionerRole \| Organization)	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(Practitioner \| PractitionerRole \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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..0	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. Data type CodeableConcept Binding Reason for event occurrence. ExampleMessageReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: MSA rim: ./conveyedAcknowledgement
focus	Σ	0..*	Reference(Resource)	There are no (further) constraints on this element Element id MessageHeader.focus Short description The actual content of the message 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(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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..0	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. Data type canonical(MessageDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not directly supported.

Anfrage Bundle

EEBAnfrageBundle (Bundle)	I		Bundle	Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `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)` -eeb-angabeOrganizationIdentifier: Im Organization-Profil muss als Identifier entweder das Institutionskennzeichen, die Betriebsstättennummer oder die KZV-Abrechnungsnummer angegeben werden. `entry.where(resource is Organization).resource.identifier.type.coding.where(code='BSNR' or code='XX' or code='KZVA').exists()` -eeb-angabePatientIdentifier: Im Patient-Profil muss entweder ein Identifier (GKV oder PKV) oder folgende Informationen (Name, Vorname, Geburtsdatum und Postleitzahl) angegeben werden. `entry.where(resource is Patient).resource.identifier.where(system='http://fhir.de/sid/gkv/kvid-10').exists() or entry.where(resource is Patient).resource.where(name.family and name.given and birthDate and address.postalCode).exists()` Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	1..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	1..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.meta.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	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.meta.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id Bundle.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
source	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
profile	Σ	1..1	canonical(StructureDefinition)Fixed Value	Element id Bundle.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://gematik.de/fhir/eeb/StructureDefinition/EEBAnfrageBundle
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Bundle.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments 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. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id Bundle.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments 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. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
identifier	Σ	1..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
id		0..1	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	I	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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Bundle.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..0	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value urn:ietf:rfc:3986 Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	Element id Bundle.identifier.value Short description Eindeutige UUID 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..0	Period	There are no (further) constraints on this element Element id Bundle.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Bundle.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
type	Σ	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value message Mappings w5: FiveWs.class
timestamp	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ I	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
link	Σ	0..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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
entry	Σ I	3..3	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 Sliced: Unordered, Closed, by resource.meta.profile(Value) Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
(All Slices)				There are no (further) constraints on this element
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	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
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
search	Σ I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match \| include \| 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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order. See Patient Match for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET \| HEAD \| POST \| PUT \| DELETE \| PATCH Definition In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates Definition Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) Definition The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned. This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error. Data type Resource
EEBAnfrageHeader	Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..0	see (link)	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	I	1..1	EEBAnfrageHeader	Element id Bundle.entry:EEBAnfrageHeader.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 EEBAnfrageHeader Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act v2: MSH / MSA / ERR rim: Message
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBAnfrageHeader.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
EEBKnownPatient	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..0	see (link)	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	I	1..1	EEBKnownPatient	Element id Bundle.entry:EEBKnownPatient.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 EEBKnownPatient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:EEBKnownPatient.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
KBV_PR_FOR_Patient	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Patient Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..0	see (link)	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Patient.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	Σ I	1..1		Element id Bundle.entry:KBV_PR_FOR_Patient.resource Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Dieses Element beschreibt eine Person, die eine oder mehrere medizinische Leistungen in Anspruch nimmt. Data type 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()` pat-de-1: Die amtliche Differenzierung der Geschlechtsangabe 'other' darf nur gefüllt sein, wenn das Geschlecht 'other' angegeben ist `gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').exists()` -for-adresszeilenAufbauPatientRessource-1: Falls die erste Adresszeile einen Straßennamen und eine Hausnummer besitzt, sind diese zusammen im Element 'line' mit einem Leerzeichen getrennt anzugeben. `(address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()) implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').value as string) + ' ' + (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').value as string)` -for-adresszeilenAufbauPatientRessource-2: Falls die erste Adresszeile keinen Straßennamen und eine Hausnummer besitzt, ist letztere im Element 'line' anzugeben. `(address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists().not()) implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').value as string)` -for-adresszeilenAufbauPatientRessource-3: Falls die erste Adresszeile keine Hausnummer und einen Straßennamen besitzt, ist letzterer im Element 'line' anzugeben. `(address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists().not() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()) implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').value as string)` -for-adresszeilenAufbauPatientRessource-4: Falls eine Adresszeile einen Adresszusatz besitzt, ist dieser im Element 'line' anzugeben. (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists() implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').value as string)) and (address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists() implies address.line[1] = (address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').value as string)) -for-adresszeilenAufbauPatientRessource-5: Falls die erste Adresszeile ein Postfach besitzt, ist dieses im Element 'line' anzugeben. `address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').exists() implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').value as string)` -for-adresszeilenAufbauPatientRessource-6: Falls die erste Adresszeile einen Straßennamen oder eine Hausnummer besitzt, darf sie keinen Adresszusatz enthalten. `(address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() or address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()) implies address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists().not()` -for-adresszeilenAufbauPatientRessource-7: Falls eine zweite Adresszeile existiert, darf sie weder einen Straßennamen oder eine Hausnummer enthalten und muss einen Adresszusatz enthalten. `address.line[1].exists() implies address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists().not() and address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists().not() and address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists()` -for-adresszeilenAufbauPatientRessource-8: Falls eine zweite Adresszeile existiert, muss die erste Adresszeile einen Straßennamen oder eine Hausnummer enthalten und darf keinen Adresszusatz besitzen. `address.line[1].exists() implies ((address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() or address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()) and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists().not())` Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Patient.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
KBV_PR_FOR_Organization	Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
link	Σ	0..0	see (link)	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	I	1..1		Element id Bundle.entry:KBV_PR_FOR_Organization.resource Short description A grouping of people or organizations with a common purpose Definition Die Einrichtung beschreibt beispielsweise den Ort, an dem ein Kontakt zwischen der zu behandelnden Person und der leistungserbringenden Person stattfindet (z.B. Praxis). Diese kann aber auch eine rein 'fiktive' Organisation zur Abrechnung sein (z.B. IK-Organisation für Hebammen). Data type Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() org-1: The organization SHALL at least have a name or an identifier, and possibly more than one `(identifier.count() + name.count()) > 0` -for-adresszeilenAufbauOrganizationRessource-1: Falls die erste Adresszeile einen Straßennamen und eine Hausnummer besitzt, sind diese zusammen im Element 'line' mit einem Leerzeichen getrennt anzugeben. `(address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()) implies address.line[0] = (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').value as string) + ' ' + (address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').value as string)` -for-adresszeilenAufbauOrganizationRessource-2: Falls die zweite Adresszeile einen Adresszusatz besitzt, ist dieser im Element 'line' anzugeben. `address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists() implies address.line[1] = (address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').value as string)` -for-adresszeilenAufbauOrganizationRessource-3: Falls die erste Adresszeile einen Straßennamen besitzt, muss sie auch eine Hausnummer enthalten. `address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists() implies address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists()` -for-adresszeilenAufbauOrganizationRessource-4: Falls die erste Adresszeile eine Hausnummer besitzt, muss sie auch einen Straßennamen enthalten. `address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() implies address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists()` -for-adresszeilenAufbauOrganizationRessource-5: Die erste Adresszeile darf keinen Adresszusatz enthalten. `address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists().not()` -for-adresszeilenAufbauOrganizationRessource-6: Falls eine zweite Adresszeile existiert, darf sie weder einen Straßennamen oder eine Hausnummer enthalten und muss einen Adresszusatz enthalten. `address.line[1].exists() implies address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists().not() and address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists().not() and address.line[1].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists()` -for-adresszeilenAufbauOrganizationRessource-7: Falls eine zweite Adresszeile existiert, muss die erste Adresszeile einen Straßennamen und eine Hausnummer enthalten und darf keinen Adresszusatz besitzen. `address.line[1].exists() implies address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').exists() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').exists() and address.line[0].extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').exists().not()` -for-anzahlIdentifikatorOrganizationRessource: Falls ein Identifikator existiert, muss entweder ein Institutskennzeichen, eine Betriebsstättennummer, eine KZV-Abrechnungsnummer oder eine Standortnummer vorhanden sein. `identifier.exists() implies (identifier.where(type.coding.code='BSNR').count()+identifier.where(type.coding.code='XX').count()+identifier.where(type.coding.code='KZVA').count()+identifier.where(type.coding.code='KSN').count()=1)` Mappings rim: Entity. Role, or Act v2: (also see master files messages) rim: Organization(classCode=ORG, determinerCode=INST) servd: Organization
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:KBV_PR_FOR_Organization.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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
signature	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`

Im folgenden Link ist ein Beispiel-Bundle Patient mit bekannter KVNR dargestellt.

Ausgestaltung der Bescheinigung

EEB-Anfragen über KIM werden nach erfolgreicher Prüfung von der Kasse mit den Coverage Profilen EEBCovergaEgkNoAddressLine bzw. EEBCoverageNoEgk abhängig beantwortet, ob der angefragte Patient eine KNVR hat oder nicht.

KVNR für Patient vorhanden

Ist die KVNR für den angefragten Patienten vorhanden, so wird in der EEBBescheinigung für die Coverage das Profil EEBCoverageEgkNoAddressLine und für den Patienten das Profil KBV_PR_FOR_Patient verwendet.

Im VSD-Container persoenlicheVersicherungsdaten des Profils EEBCoverageNoAddressLine werden in der Straßenadresse die Werte für Straße und Hausnummer nicht gesetzt.
Im VSD-Container allgemeineVersicherungsdaten ist der Versicherungsbeginn ein muss-Feld. Daher wird ein fiktiver Versicherungsbeginn konstant auf 01.01.1900 gesetzt. Dieses Datum repräsentiert nicht den wahren Versicherungsbeginn des Versicherten und darf für weitere Geschäftsfunktionen, z.B. Abrechnungsmodalitäten, nicht verwendet werden.
Im Profil KBV_PR_FOR_Patient wird das Feld address.line inklusive der extensions der Straßenanschrift weggelassen, damit entfallen zusätzlich die Felder Strasse, Hausnummer und Adresszusatz.

KVNR für Patient nicht vorhanden

Besitzt der Patient noch keine KVNR (z.B. Neugeborene) sowie wird das Coverage Profil EEBCoverageNoEgk verwendet. In diesem Profil gibt es weder einen Versicherungsbeginn noch eine Straßenadresse, so dass sich die geforderten Adresseinschränkungen nur im Profil KBV_PR_FOR_Patient auswirken. D.h. auch in dieser Konstellation (EEBCoverageNoEgk) werden im Profil KBV_PR_FOR_Patient das Feld line der Straßenanschrift weggelassen.