FHIR Messaging
This is the FHIR version of traditional messaging. It differs from FHIR RESTful in that all the resources are sent to the recipient in one interaction. This is particularly useful between organisations where all the FHIR resources can be sent in one interaction.
E.g. in the diagram below a prescription consists of one Patient resource and two MedicationRequests. Using FHIR Messaging all the resources are sent within one FHIR Message Bundle. Doing the same with FHIR RESTful would require at least three transactions (possibly more depending on the handling of the Patient resource).
FHIR Message reduces the number of transactions and decouples the sending organisation from local rules. All the resources are handled in a single package and the receiving organisation can handle them according to local procedures.
FHIR Messaging is very similar to the messaging used in HL7 v2 and HL7 v3 (/ITK), hence the term traditional messaging.
FHIR Bundle (type=message)
| Profile url |
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https://fhir.nhs.uk/StructureDefinition/NHSDigital-Bundle-FHIRMessage |
| NHSDigitalBundleFHIRMessage (Bundle) | I | Bundle | There are no (further) constraints on this element Element idBundle Contains a collection of resources DefinitionA container for a collection of resources.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idBundle.meta Metadata about the resource DefinitionThe 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.
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idBundle.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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| identifier | Σ | 1..1 | Identifier | There are no (further) constraints on this element Element idBundle.identifier Persistent identifier for the bundle DefinitionA persistent identifier for the bundle that won't change as a bundle is copied from server to server. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idBundle.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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| assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idBundle.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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| type | Σ | 1..1 | codeBindingFixed Value | Element idBundle.type document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection DefinitionIndicates the purpose of this bundle - how it is intended to be used. 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. Indicates the purpose of a bundle - how it is intended to be used.
message
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| timestamp | Σ | 1..1 | instant | There are no (further) constraints on this element Element idBundle.timestamp When the bundle was assembled DefinitionThe date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. 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:
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.
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| total | Σ I | 0..1 | unsignedInt | There are no (further) constraints on this element Element idBundle.total If search, the total number of matches DefinitionIf 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. 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.
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| link | Σ | 0..0 | BackboneElement | There are no (further) constraints on this element Element idBundle.link Links related to this Bundle DefinitionA series of links that provide context to this bundle. 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.
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| entry | Σ I | 1..* | BackboneElement | Element idBundle.entry Entry in the bundle - will have a resource or information DefinitionAn entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Unordered, Open, by resource.resourceType(Value) Constraints
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| (All Slices) | There are no (further) constraints on this element | |||
| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| link | Σ | 0..0 | see (link) | There are no (further) constraints on this element Element idBundle.entry.link Links related to this entry DefinitionA series of links that provide context to this entry. |
| fullUrl | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.entry.fullUrl URI for resource (Absolute URL server address or URI for UUID/OID) DefinitionThe 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 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).
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| resource | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.resource A resource in the bundle DefinitionThe Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
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| search | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.search Search related information DefinitionInformation about the search process that lead to the creation of this entry.
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| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.search.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| mode | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.search.mode match | include | outcome - why this is in the result set DefinitionWhy 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. 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. 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.
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| score | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idBundle.entry.search.score Search ranking (between 0 and 1) DefinitionWhen searching, the server's search ranking score for the entry. 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.
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| request | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.request Additional execution information (transaction/batch/history) DefinitionAdditional 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| method | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.request.method GET | HEAD | POST | PUT | DELETE | PATCH DefinitionIn 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. Note that FHIR strings SHALL NOT exceed 1MB in size HTTP verbs (in the HTTP command line). See HTTP rfc for details.
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| url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.entry.request.url URL for HTTP equivalent of this entry DefinitionThe URL for this entry, relative to the root (the address to which the request is posted). 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]".
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| ifNoneMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneMatch For managing cache currency DefinitionIf the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Note that FHIR strings SHALL NOT exceed 1MB in size
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| ifModifiedSince | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.request.ifModifiedSince For managing cache currency DefinitionOnly perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
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| ifMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifMatch For managing update contention DefinitionOnly perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Note that FHIR strings SHALL NOT exceed 1MB in size
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| ifNoneExist | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneExist For conditional creates DefinitionInstruct 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 "?"). Note that FHIR strings SHALL NOT exceed 1MB in size
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| response | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.response Results of execution (transaction/batch/history) DefinitionIndicates 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| status | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.status Status response code (text optional) DefinitionThe 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. Note that FHIR strings SHALL NOT exceed 1MB in size
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| location | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry.response.location The location (if the operation returns a location) DefinitionThe location header created by processing this operation, populated if the operation returns a location. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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| etag | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.etag The Etag for the resource (if relevant) DefinitionThe Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
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| lastModified | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.response.lastModified Server's date time modified DefinitionThe date/time that the resource was modified on the server. This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
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| outcome | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.response.outcome OperationOutcome with hints and warnings (for batch/transaction) DefinitionAn OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. 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.
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| messageHeader | Σ I | 1..* | BackboneElement | There are no (further) constraints on this element Element idBundle.entry:messageHeader Entry in the bundle - will have a resource or information DefinitionAn entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
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| id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry:messageHeader.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry:messageHeader.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry:messageHeader.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| link | Σ | 0..* | see (link) | There are no (further) constraints on this element Element idBundle.entry:messageHeader.link Links related to this entry DefinitionA series of links that provide context to this entry. |
| fullUrl | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry:messageHeader.fullUrl URI for resource (Absolute URL server address or URI for UUID/OID) DefinitionThe 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 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).
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| resource | Σ I | 0..1 | Element idBundle.entry:messageHeader.resource A resource that describes a message that is exchanged between systems DefinitionThe 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.
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| search | Σ I | 0..0 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry:messageHeader.search Search related information DefinitionInformation about the search process that lead to the creation of this entry.
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| request | Σ I | 0..0 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry:messageHeader.request Additional execution information (transaction/batch/history) DefinitionAdditional 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.
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| response | Σ I | 0..0 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry:messageHeader.response Results of execution (transaction/batch/history) DefinitionIndicates 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.
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| signature | Σ | 0..1 | Signature | There are no (further) constraints on this element Element idBundle.signature Digital Signature DefinitionDigital Signature - base64 encoded. XML-DSig or a JWT. A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.
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This message consists of a Bundle identified by the type "message", with the first resource in the bundle being a MessageHeader resource. The MessageHeader resource has a code - the message event - that identifies the nature of the request message, and it also carries additional request metadata. The other resources in the bundle depend on the type of the request.
For example a dispense-notification message will be a FHIR Bundle consisting of
- one MessageHeader resource with an eventCoding
dispense-notification - one to four MedicationDispense resources
- one (optional) Patient resource.
Example dispense-notifications can be found in the NHS Digital Medicines Guide Examples
These Bundles are send to a $process-message operation, e.g.
POST baseUrl/$process-message
In the example above we stated rules for the dispense-notification message, these will be contained in a FHIR MessageDefinition and the message definition for this is
https://fhir.nhs.uk/MessageDefinition/pharmacy-dispense
{
"resourceType": "MessageDefinition",
"id": "pharmacy-dispense",
"url": "https://fhir.nhs.uk/MessageDefinition/pharmacy-dispense",
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "bf729ea8-280b-4109-b2f5-02ce8e51d870"
}
],
"version": "1.0.0",
"title": "Pharmacy/Treatment Dispense",
"status": "active",
"date": "2020-10-02",
"eventCoding": {
"system": "https://fhir.nhs.uk/CodeSystem/message-event",
"code": "dispense-notification",
"display": "Dispense Notification"
},
"category": "notification",
"focus": [
{
"code": "MedicationDispense",
"profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense",
"min": 1,
"max": "4"
}
]
}
Some of the key points are:
- element eventCoding This is the code that identifies the MessageDefinition and will match the eventingCode in the
dispense-notificationFHIR Message - element focus This lists the principal resources; in the example this is FHIR MedicationDispense resources which follows the NHSDigital-MedicationDispense profile. One and up to four resources can be supplied.
- Patient resource is not in the focus section. The rule that a Patient resource is required is contained in the FHIR MedicationDispense profile.
- MessageHeader resource is not in the focuse section. It is mandatory in all FHIR Messages.
The FHIR MessageHeader contains the message metadata only and is designed to support message handling without having to process the full message. The use of FHIR MessageHeader with NHSDigital API's is discussed in NHSDigital-MessageHeader. Note this FHIR R4 NHSDigital-MessageHeader is designed to handle all message types and contains rules from both previous MessageHeaders used in Transfer of Care (point to point messages) and National Event Messaging System (pub/sub messages).