Alberta Patient Summary Implementation Guide 1.1.0

Profile: Bundle

PS-AB Simplifier Project Page: package/StructureDefinition-BundlePSAB.json

Derived from PS-CA Bundle

Views of Profile Content

BundlePSAB (Bundle)	I		BundlePSCA	Element id Bundle Short description PS-CA Bundle Definition PS-CA Bundle. A container for a collection of resources in the patient summary. Data type BundlePSCA Constraints bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited `entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))` bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited `entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `entry.search.empty() or (type = 'searchset')` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-ps-1: A PS document must have no additional Composition (including Composition subclass) resources besides the first `entry.tail().where(resource is Composition).empty()` psab-bdl-1: If Bundle.Composition.title is Patient Summary - AB, then the following details SHALL NOT be present in all resources within the bundle instance except the bundle itself: contained `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.resource.where(contained.exists()).exists().not()` psab-bdl-ait-1: If Bundle.Composition.title is Patient Summary - AB, then the following AllergyIntolerance details SHALL NOT be present: verificationStatus, encounter, recorder, asserter Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is AllergyIntolerance).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(asserter.exists()).exists().not() psab-bdl-con-1: If Bundle.Composition.title is Patient Summary - AB, then the following Condition details SHALL NOT be present: verificationStatus, severity, encounter, abatement, recorder, asserter, stage, evidence Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Condition).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(severity.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(abatement.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(asserter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(stage.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(evidence.exists()).exists().not() psab-bdl-fhs-1: If Bundle.Composition.title is Patient Summary - AB, then the following FamilyMemberHistory details SHALL NOT be present: instantiatesCanonical, instantiatesUri, reasonReference, condition.outcome, condition.contributedToDeath Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesCanonical.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesUri.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.outcome.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.contributedToDeath.exists()).exists().not() psab-bdl-loc-1: If Bundle.Composition.title is Patient Summary - AB then the following Location details SHALL NOT be present: telecom.use, and address.use, managingOrganization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Location).resource.where(telecom.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(address.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(managingOrganization.exists()).exists().not()` psab-bdl-med-2: If Bundle.Composition.title is Patient Summary - AB, then the following Medication details SHALL NOT be present: status, manufacturer, amount, ingredient, batch Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Medication).resource.where(status.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(manufacturer.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(amount.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(ingredient.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(batch.exists()).exists().not() psab-bdl-mst-1: If Bundle.Composition.title is Patient Summary - AB, then the following MedicationStatement details SHALL NOT be present: context, dateAsserted, informationSource, derivedFrom, reasonReference, basedOn, partOf Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is MedicationStatement).resource.where(context.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(dateAsserted.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(informationSource.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(derivedFrom.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(basedOn.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(partOf.exists()).exists().not() psab-bdl-obs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observations SHALL NOT be present: body temperature, heart rate, oxygen saturation, respiratory rate, vital signs panel `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.code.coding.exists(code in ('8310-5'\|'8867-4'\|'2708-6'\|'9279-1'\|'85353-1')).not()` psab-bdl-obs-vs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observation details SHALL NOT be present: basedOn, partOf, category.extension, category.coding.extension, code.extension, focus, encounter, issued, value.extension, dataAbsentReason , derivedFrom, specimen, device and performer. `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or category.extension or category.coding.extension or code.extension or focus or encounter or issued or value.extension or dataAbsentReason or derivedFrom or specimen or device) and category.coding.code in ('vital-signs')).exists().not()` psab-bdl-obs-sh-1: If Bundle.Composition.title is Patient Summary - AB, then the following social history observation details SHALL NOT be present: basedOn, partOf, focus, encounter, hasMember, derivedFrom, device, and specimen `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or focus or encounter or hasMember or derivedFrom or specimen or device or performer) and category.coding.code in ('social-history')).exists().not()` psab-bdl-pat-1: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL NOT be present: text, active, address.text, maritalStatus, multipleBirth, photo, contact.gender, contact.organization, contact.period, generalPractitioner, managingOrganization Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.where(text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(active.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(address.text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(maritalStatus.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(multipleBirth.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.gender.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.organization.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.period.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(generalPractitioner.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(managingOrganization.exists()).exists().not() psab-bdl-pat-2: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL be present: telecom:Phone `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.telecom.where(system = 'phone').exists()` psab-bdl-prc-1: If Bundle.Composition.title is Patient Summary - AB, then the following Practitioner details SHALL NOT be present: photo, qualification, and birthDate `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Practitioner).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(qualification.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(birthDate.exists()).exists().not()` psab-bdl-prl-1: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL NOT be present: healthcareService, organization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(healthcareService.exists()).exists().not() and Bundle.entry.where(resource is PractitionerRole).resource.where(organization.exists()).exists().not()` psab-bdl-prl-2: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL be present: specialty.coding.code `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(specialty.coding.code.exists()).exists()` Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta 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
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	1..*	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 rim: N/A
submissionMetadata	S I	1..*	Extension(Complex)	Element id Bundle.meta.extension:submissionMetadata Short description Entity Identifier and Name Alternate names extensions, user content Definition An extension that contains an entity identifier and name for use in the context of a Bundle Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(Complex) Extension URL https://www.alberta.ca/fhir/psab/StructureDefinition/ext-EntityIdentifierAndName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
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())` Mappings rim: n/a
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())` Mappings rim: n/a
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())` Mappings rim: n/a
profile	Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element 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())` Mappings rim: n/a
security	S Σ	0..*	CodingBinding	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. SecurityLabel (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
identifier	S Σ	1..1	Identifier	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 rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier cda: ClinicalDocument.id
type	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element 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 document Mappings rim: n/a w5: FiveWs.class
timestamp	S Σ	1..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction \| transaction-response \| batch \| batch-response \| collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ I	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Comments Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
link	Σ	0..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())` Mappings rim: n/a
entry	S Σ I	2..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry resource in the patient summary bundle Definition An entry resource included in the patient summary bundle resource. Comments Must contain at a minimum the PS-CA Composition as the first entry (only a single Composition resource may be included) and a Patient Resource. Additional constraints that determine what is included in the bundle are specified in the PS-CA Composition profile. Data type BackboneElement Sliced: Unordered, Open, by resource(Type), resource(Profile) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
(All Slices)				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 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 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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..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())` Mappings rim: n/a
resource	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. Data type Resource Mappings rim: Entity. Role, or Act
search	Σ I	0..0	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())` Mappings rim: n/a
request	Σ I	0..0	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())` Mappings rim: n/a
response	Σ I	0..0	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())` Mappings rim: n/a
composition	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition 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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:composition.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:composition.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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:composition.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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:composition.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
resource	S Σ I	1..1	CompositionPSAB	Element id Bundle.entry:composition.resource Short description Canadian Patient Summary composition Definition Canadian Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. Comments While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical. Data type CompositionPSAB 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()` psab-cmp-1: If Composition.title is Patient Summary - AB, then the following elements SHALL NOT be present: relatesTo, event, encounter, section.focus `Composition.title = 'Patient Summary - AB' implies attester.exists().not() and relatesTo.exists().not() and event.exists().not() and encounter.exists().not() and where(section.focus.exists().not())` psab-cmp-2: If Composition.title is Patient Summary - AB, then the following sections SHALL NOT be present: sectionImmunizations, sectionMedicalDevices, sectionResults, sectionPastIllnessHx, sectionFunctionalStatus, sectionPlanOfCare, sectionPregnancyHx, sectionAdvanceDirectives Composition.title = 'Patient Summary - AB' implies section.code.coding.where(code = '11369-6').exists().not() and section.code.coding.where(code = '46264-8').exists().not() and section.code.coding.where(code = '30954-2').exists().not() and section.code.coding.where(code = '11348-0').exists().not() and section.code.coding.where(code = '47420-5').exists().not() and section.code.coding.where(code = '18776-5').exists().not() and section.code.coding.where(code = '10162-6').exists().not() and section.code.coding.where(code = '42348-3').exists().not() Mappings rim: Entity. Role, or Act workflow: Event rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()] cda: ClinicalDocument fhirdocumentreference: when described by DocumentReference
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
patient	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry: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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:patient.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
resource	S Σ I	1..1	PatientPSAB	Element id Bundle.entry:patient.resource Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Comments Patient resources included in Alberta Patient Summary Document Bundles have rules that certain attributes are not to be contained in Patient resource. These are mechanically enforced through invariants at the PS-AB Bundle level. Data type PatientPSAB Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act 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: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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.request Short description Additional execution information (transaction/batch/history) Definition Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.response Short description Results of execution (transaction/batch/history) Definition Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWT. Requirements A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. Comments The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific. Data type Signature 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

BundlePSAB (Bundle)	I		BundlePSCA	Element id Bundle Short description PS-CA Bundle Definition PS-CA Bundle. A container for a collection of resources in the patient summary. Data type BundlePSCA Constraints bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited `entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))` bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited `entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `entry.search.empty() or (type = 'searchset')` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-ps-1: A PS document must have no additional Composition (including Composition subclass) resources besides the first `entry.tail().where(resource is Composition).empty()` psab-bdl-1: If Bundle.Composition.title is Patient Summary - AB, then the following details SHALL NOT be present in all resources within the bundle instance except the bundle itself: contained `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.resource.where(contained.exists()).exists().not()` psab-bdl-ait-1: If Bundle.Composition.title is Patient Summary - AB, then the following AllergyIntolerance details SHALL NOT be present: verificationStatus, encounter, recorder, asserter Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is AllergyIntolerance).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(asserter.exists()).exists().not() psab-bdl-con-1: If Bundle.Composition.title is Patient Summary - AB, then the following Condition details SHALL NOT be present: verificationStatus, severity, encounter, abatement, recorder, asserter, stage, evidence Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Condition).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(severity.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(abatement.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(asserter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(stage.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(evidence.exists()).exists().not() psab-bdl-fhs-1: If Bundle.Composition.title is Patient Summary - AB, then the following FamilyMemberHistory details SHALL NOT be present: instantiatesCanonical, instantiatesUri, reasonReference, condition.outcome, condition.contributedToDeath Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesCanonical.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesUri.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.outcome.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.contributedToDeath.exists()).exists().not() psab-bdl-loc-1: If Bundle.Composition.title is Patient Summary - AB then the following Location details SHALL NOT be present: telecom.use, and address.use, managingOrganization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Location).resource.where(telecom.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(address.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(managingOrganization.exists()).exists().not()` psab-bdl-med-2: If Bundle.Composition.title is Patient Summary - AB, then the following Medication details SHALL NOT be present: status, manufacturer, amount, ingredient, batch Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Medication).resource.where(status.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(manufacturer.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(amount.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(ingredient.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(batch.exists()).exists().not() psab-bdl-mst-1: If Bundle.Composition.title is Patient Summary - AB, then the following MedicationStatement details SHALL NOT be present: context, dateAsserted, informationSource, derivedFrom, reasonReference, basedOn, partOf Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is MedicationStatement).resource.where(context.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(dateAsserted.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(informationSource.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(derivedFrom.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(basedOn.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(partOf.exists()).exists().not() psab-bdl-obs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observations SHALL NOT be present: body temperature, heart rate, oxygen saturation, respiratory rate, vital signs panel `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.code.coding.exists(code in ('8310-5'\|'8867-4'\|'2708-6'\|'9279-1'\|'85353-1')).not()` psab-bdl-obs-vs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observation details SHALL NOT be present: basedOn, partOf, category.extension, category.coding.extension, code.extension, focus, encounter, issued, value.extension, dataAbsentReason , derivedFrom, specimen, device and performer. `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or category.extension or category.coding.extension or code.extension or focus or encounter or issued or value.extension or dataAbsentReason or derivedFrom or specimen or device) and category.coding.code in ('vital-signs')).exists().not()` psab-bdl-obs-sh-1: If Bundle.Composition.title is Patient Summary - AB, then the following social history observation details SHALL NOT be present: basedOn, partOf, focus, encounter, hasMember, derivedFrom, device, and specimen `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or focus or encounter or hasMember or derivedFrom or specimen or device or performer) and category.coding.code in ('social-history')).exists().not()` psab-bdl-pat-1: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL NOT be present: text, active, address.text, maritalStatus, multipleBirth, photo, contact.gender, contact.organization, contact.period, generalPractitioner, managingOrganization Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.where(text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(active.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(address.text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(maritalStatus.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(multipleBirth.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.gender.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.organization.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.period.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(generalPractitioner.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(managingOrganization.exists()).exists().not() psab-bdl-pat-2: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL be present: telecom:Phone `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.telecom.where(system = 'phone').exists()` psab-bdl-prc-1: If Bundle.Composition.title is Patient Summary - AB, then the following Practitioner details SHALL NOT be present: photo, qualification, and birthDate `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Practitioner).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(qualification.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(birthDate.exists()).exists().not()` psab-bdl-prl-1: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL NOT be present: healthcareService, organization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(healthcareService.exists()).exists().not() and Bundle.entry.where(resource is PractitionerRole).resource.where(organization.exists()).exists().not()` psab-bdl-prl-2: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL be present: specialty.coding.code `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(specialty.coding.code.exists()).exists()` Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta 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
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	1..*	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 rim: N/A
submissionMetadata	S I	1..*	Extension(Complex)	Element id Bundle.meta.extension:submissionMetadata Short description Entity Identifier and Name Alternate names extensions, user content Definition An extension that contains an entity identifier and name for use in the context of a Bundle Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(Complex) Extension URL https://www.alberta.ca/fhir/psab/StructureDefinition/ext-EntityIdentifierAndName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
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())` Mappings rim: n/a
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())` Mappings rim: n/a
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())` Mappings rim: n/a
profile	Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element 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())` Mappings rim: n/a
security	S Σ	0..*	CodingBinding	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. SecurityLabel (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
identifier	S Σ	1..1	Identifier	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 rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier cda: ClinicalDocument.id
type	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element 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 document Mappings rim: n/a w5: FiveWs.class
timestamp	S Σ	1..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction \| transaction-response \| batch \| batch-response \| collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ I	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Comments Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
link	Σ	0..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())` Mappings rim: n/a
entry	S Σ I	2..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry resource in the patient summary bundle Definition An entry resource included in the patient summary bundle resource. Comments Must contain at a minimum the PS-CA Composition as the first entry (only a single Composition resource may be included) and a Patient Resource. Additional constraints that determine what is included in the bundle are specified in the PS-CA Composition profile. Data type BackboneElement Sliced: Unordered, Open, by resource(Type), resource(Profile) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
(All Slices)				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 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 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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..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())` Mappings rim: n/a
resource	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. Data type Resource Mappings rim: Entity. Role, or Act
search	Σ I	0..0	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())` Mappings rim: n/a
request	Σ I	0..0	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())` Mappings rim: n/a
response	Σ I	0..0	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())` Mappings rim: n/a
composition	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition 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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:composition.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:composition.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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:composition.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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:composition.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
resource	S Σ I	1..1	CompositionPSAB	Element id Bundle.entry:composition.resource Short description Canadian Patient Summary composition Definition Canadian Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. Comments While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical. Data type CompositionPSAB 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()` psab-cmp-1: If Composition.title is Patient Summary - AB, then the following elements SHALL NOT be present: relatesTo, event, encounter, section.focus `Composition.title = 'Patient Summary - AB' implies attester.exists().not() and relatesTo.exists().not() and event.exists().not() and encounter.exists().not() and where(section.focus.exists().not())` psab-cmp-2: If Composition.title is Patient Summary - AB, then the following sections SHALL NOT be present: sectionImmunizations, sectionMedicalDevices, sectionResults, sectionPastIllnessHx, sectionFunctionalStatus, sectionPlanOfCare, sectionPregnancyHx, sectionAdvanceDirectives Composition.title = 'Patient Summary - AB' implies section.code.coding.where(code = '11369-6').exists().not() and section.code.coding.where(code = '46264-8').exists().not() and section.code.coding.where(code = '30954-2').exists().not() and section.code.coding.where(code = '11348-0').exists().not() and section.code.coding.where(code = '47420-5').exists().not() and section.code.coding.where(code = '18776-5').exists().not() and section.code.coding.where(code = '10162-6').exists().not() and section.code.coding.where(code = '42348-3').exists().not() Mappings rim: Entity. Role, or Act workflow: Event rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()] cda: ClinicalDocument fhirdocumentreference: when described by DocumentReference
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
patient	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry: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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:patient.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
resource	S Σ I	1..1	PatientPSAB	Element id Bundle.entry:patient.resource Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Comments Patient resources included in Alberta Patient Summary Document Bundles have rules that certain attributes are not to be contained in Patient resource. These are mechanically enforced through invariants at the PS-AB Bundle level. Data type PatientPSAB Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act 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: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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.request Short description Additional execution information (transaction/batch/history) Definition Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.response Short description Results of execution (transaction/batch/history) Definition Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWT. Requirements A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. Comments The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific. Data type Signature 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

BundlePSAB (Bundle)	I		BundlePSCA	Element id Bundle Short description PS-CA Bundle Definition PS-CA Bundle. A container for a collection of resources in the patient summary. Data type BundlePSCA Constraints bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) `(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()` bdl-9: A document must have an identifier with a system and a value `type = 'document' implies (identifier.system.exists() and identifier.value.exists())` bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited `entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))` bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited `entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))` bdl-12: A message must have a MessageHeader as the first resource `type = 'message' implies entry.first().resource.is(MessageHeader)` bdl-1: total only when a search or history `total.empty() or (type = 'searchset') or (type = 'history')` bdl-2: entry.search only when a search `entry.search.empty() or (type = 'searchset')` bdl-11: A document must have a Composition as the first resource `type = 'document' implies entry.first().resource.is(Composition)` bdl-10: A document must have a date `type = 'document' implies (timestamp.hasValue())` bdl-ps-1: A PS document must have no additional Composition (including Composition subclass) resources besides the first `entry.tail().where(resource is Composition).empty()` psab-bdl-1: If Bundle.Composition.title is Patient Summary - AB, then the following details SHALL NOT be present in all resources within the bundle instance except the bundle itself: contained `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.resource.where(contained.exists()).exists().not()` psab-bdl-ait-1: If Bundle.Composition.title is Patient Summary - AB, then the following AllergyIntolerance details SHALL NOT be present: verificationStatus, encounter, recorder, asserter Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is AllergyIntolerance).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is AllergyIntolerance).resource.where(asserter.exists()).exists().not() psab-bdl-con-1: If Bundle.Composition.title is Patient Summary - AB, then the following Condition details SHALL NOT be present: verificationStatus, severity, encounter, abatement, recorder, asserter, stage, evidence Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Condition).resource.where(verificationStatus.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(severity.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(encounter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(abatement.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(recorder.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(asserter.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(stage.exists()).exists().not() and Bundle.entry.where(resource is Condition).resource.where(evidence.exists()).exists().not() psab-bdl-fhs-1: If Bundle.Composition.title is Patient Summary - AB, then the following FamilyMemberHistory details SHALL NOT be present: instantiatesCanonical, instantiatesUri, reasonReference, condition.outcome, condition.contributedToDeath Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesCanonical.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(instantiatesUri.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.outcome.exists()).exists().not() and Bundle.entry.where(resource is FamilyMemberHistory).resource.where(condition.contributedToDeath.exists()).exists().not() psab-bdl-loc-1: If Bundle.Composition.title is Patient Summary - AB then the following Location details SHALL NOT be present: telecom.use, and address.use, managingOrganization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Location).resource.where(telecom.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(address.use.exists()).exists().not() and Bundle.entry.where(resource is Location).resource.where(managingOrganization.exists()).exists().not()` psab-bdl-med-2: If Bundle.Composition.title is Patient Summary - AB, then the following Medication details SHALL NOT be present: status, manufacturer, amount, ingredient, batch Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Medication).resource.where(status.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(manufacturer.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(amount.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(ingredient.exists()).exists().not() and Bundle.entry.where(resource is Medication).resource.where(batch.exists()).exists().not() psab-bdl-mst-1: If Bundle.Composition.title is Patient Summary - AB, then the following MedicationStatement details SHALL NOT be present: context, dateAsserted, informationSource, derivedFrom, reasonReference, basedOn, partOf Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is MedicationStatement).resource.where(context.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(dateAsserted.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(informationSource.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(derivedFrom.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(reasonReference.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(basedOn.exists()).exists().not() and Bundle.entry.where(resource is MedicationStatement).resource.where(partOf.exists()).exists().not() psab-bdl-obs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observations SHALL NOT be present: body temperature, heart rate, oxygen saturation, respiratory rate, vital signs panel `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.code.coding.exists(code in ('8310-5'\|'8867-4'\|'2708-6'\|'9279-1'\|'85353-1')).not()` psab-bdl-obs-vs-1: If Bundle.Composition.title is Patient Summary - AB, then the following vital sign observation details SHALL NOT be present: basedOn, partOf, category.extension, category.coding.extension, code.extension, focus, encounter, issued, value.extension, dataAbsentReason , derivedFrom, specimen, device and performer. `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or category.extension or category.coding.extension or code.extension or focus or encounter or issued or value.extension or dataAbsentReason or derivedFrom or specimen or device) and category.coding.code in ('vital-signs')).exists().not()` psab-bdl-obs-sh-1: If Bundle.Composition.title is Patient Summary - AB, then the following social history observation details SHALL NOT be present: basedOn, partOf, focus, encounter, hasMember, derivedFrom, device, and specimen `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Observation).resource.where((basedOn or partOf or focus or encounter or hasMember or derivedFrom or specimen or device or performer) and category.coding.code in ('social-history')).exists().not()` psab-bdl-pat-1: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL NOT be present: text, active, address.text, maritalStatus, multipleBirth, photo, contact.gender, contact.organization, contact.period, generalPractitioner, managingOrganization Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.where(text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(active.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(address.text.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(maritalStatus.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(multipleBirth.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.gender.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.organization.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(contact.period.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(generalPractitioner.exists()).exists().not() and Bundle.entry.where(resource is Patient).resource.where(managingOrganization.exists()).exists().not() psab-bdl-pat-2: If Bundle.Composition.title is Patient Summary - AB, then the following Patient details SHALL be present: telecom:Phone `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Patient).resource.telecom.where(system = 'phone').exists()` psab-bdl-prc-1: If Bundle.Composition.title is Patient Summary - AB, then the following Practitioner details SHALL NOT be present: photo, qualification, and birthDate `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is Practitioner).resource.where(photo.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(qualification.exists()).exists().not() and Bundle.entry.where(resource is Practitioner).resource.where(birthDate.exists()).exists().not()` psab-bdl-prl-1: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL NOT be present: healthcareService, organization `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(healthcareService.exists()).exists().not() and Bundle.entry.where(resource is PractitionerRole).resource.where(organization.exists()).exists().not()` psab-bdl-prl-2: If Bundle.Composition.title is Patient Summary - AB, then the following PractitionerRole details SHALL be present: specialty.coding.code `Bundle.entry.where(resource is Composition).resource.where(title = 'Patient Summary - AB') implies Bundle.entry.where(resource is PractitionerRole).resource.where(specialty.coding.code.exists()).exists()` Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
id	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta 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
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	1..*	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 rim: N/A
submissionMetadata	S I	1..*	Extension(Complex)	Element id Bundle.meta.extension:submissionMetadata Short description Entity Identifier and Name Alternate names extensions, user content Definition An extension that contains an entity identifier and name for use in the context of a Bundle Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that 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(Complex) Extension URL https://www.alberta.ca/fhir/psab/StructureDefinition/ext-EntityIdentifierAndName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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
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())` Mappings rim: n/a
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())` Mappings rim: n/a
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())` Mappings rim: n/a
profile	Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element 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())` Mappings rim: n/a
security	S Σ	0..*	CodingBinding	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. SecurityLabel (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
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())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
identifier	S Σ	1..1	Identifier	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 rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier cda: ClinicalDocument.id
type	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element 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 document Mappings rim: n/a w5: FiveWs.class
timestamp	S Σ	1..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction \| transaction-response \| batch \| batch-response \| collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.init cda: ClinicalDocument.effectiveTime
total	Σ I	0..1	unsignedInt	There are no (further) constraints on this element Element id Bundle.total Short description If search, the total number of matches Definition If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Comments Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
link	Σ	0..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())` Mappings rim: n/a
entry	S Σ I	2..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry Short description Entry resource in the patient summary bundle Definition An entry resource included in the patient summary bundle resource. Comments Must contain at a minimum the PS-CA Composition as the first entry (only a single Composition resource may be included) and a Patient Resource. Additional constraints that determine what is included in the bundle are specified in the PS-CA Composition profile. Data type BackboneElement Sliced: Unordered, Open, by resource(Type), resource(Profile) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
(All Slices)				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 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 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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..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())` Mappings rim: n/a
resource	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. Data type Resource Mappings rim: Entity. Role, or Act
search	Σ I	0..0	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())` Mappings rim: n/a
request	Σ I	0..0	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())` Mappings rim: n/a
response	Σ I	0..0	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())` Mappings rim: n/a
composition	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition 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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:composition.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:composition.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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:composition.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 rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:composition.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	S Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
resource	S Σ I	1..1	CompositionPSAB	Element id Bundle.entry:composition.resource Short description Canadian Patient Summary composition Definition Canadian Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. Comments While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical. Data type CompositionPSAB 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()` psab-cmp-1: If Composition.title is Patient Summary - AB, then the following elements SHALL NOT be present: relatesTo, event, encounter, section.focus `Composition.title = 'Patient Summary - AB' implies attester.exists().not() and relatesTo.exists().not() and event.exists().not() and encounter.exists().not() and where(section.focus.exists().not())` psab-cmp-2: If Composition.title is Patient Summary - AB, then the following sections SHALL NOT be present: sectionImmunizations, sectionMedicalDevices, sectionResults, sectionPastIllnessHx, sectionFunctionalStatus, sectionPlanOfCare, sectionPregnancyHx, sectionAdvanceDirectives Composition.title = 'Patient Summary - AB' implies section.code.coding.where(code = '11369-6').exists().not() and section.code.coding.where(code = '46264-8').exists().not() and section.code.coding.where(code = '30954-2').exists().not() and section.code.coding.where(code = '11348-0').exists().not() and section.code.coding.where(code = '47420-5').exists().not() and section.code.coding.where(code = '18776-5').exists().not() and section.code.coding.where(code = '10162-6').exists().not() and section.code.coding.where(code = '42348-3').exists().not() Mappings rim: Entity. Role, or Act workflow: Event rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()] cda: ClinicalDocument fhirdocumentreference: when described by DocumentReference
search	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:composition.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())` Mappings rim: n/a
patient	S Σ I	1..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry: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 ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` bdl-8: fullUrl cannot be a version specific reference `fullUrl.contains('/_history/').not()` bdl-5: must be a resource unless there's a request or response `resource.exists() or request.exists() or response.exists()` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:patient.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:patient.link Short description Links related to this entry Definition A series of links that provide context to this entry.
fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:patient.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
resource	S Σ I	1..1	PatientPSAB	Element id Bundle.entry:patient.resource Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Comments Patient resources included in Alberta Patient Summary Document Bundles have rules that certain attributes are not to be contained in Patient resource. These are mechanically enforced through invariants at the PS-AB Bundle level. Data type PatientPSAB Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act 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: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())` Mappings rim: n/a
request	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.request Short description Additional execution information (transaction/batch/history) Definition Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
response	Σ I	0..0	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:patient.response Short description Results of execution (transaction/batch/history) Definition Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWT. Requirements A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. Comments The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific. Data type Signature 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

Usage

The Bundle resource gathers all the content of the patient summary into a single document for exchange. The patient summary is a Bundle of type "document" that has a Composition resource as the first resource in the bundle, followed by a series of other resources, referenced from the Composition resource, that provide supporting evidence for the document.

The Bundle resource contains several invariants that implement contraints on various resources.

.id

used to uniquely identify the resource
assigned by Alberta Health upon successful validation of submitted PS-AB instance and will be a new UUID per each instance of a PS-AB
EMRs SHOULD be able to retain the Bundle.id assigned by Alberta Health.
Note: Alberta Health will make location (using Bundle.id) resolvable

.meta

.security MAY be populated.
When .security is populated it SHALL contain the security code for Composition confidentiality. Optionally, it MAY also contain the security code for patient and provider's expressed wish.
- "R" (Restricted) SHALL be used for Composition confidentiality. NOTE: This is also replicated in Composition.confidentiality attribute
- "PRS" (Patient requested information sensitivity) SHALL be used for patient expressed wish
- "PHY" (Physician requested information sensitivity) SHALL be used for physician information sensitivity request

.identifier

SHALL always be populated
SHALL be assigned by Source EMR
SHALL be a UUID
SHALL be unique for each instance of a Bundle including when resubmitted
SHALL be retained for the lifetime of a Bundle

.entry.fullUrl

each entry in the Bundle SHALL have a fullUrl which is a UUID (urn:uuid)

Extensions

meta.extension.submissionMetadata

SHALL always be populated
the following submission metadata are supported and captured in corresponding attribute:
- Submitting Site ID (extension.entityIdentifier.valueIdentifier)
  - SHALL be a valid provincially-assigned delivery site identifier (e.g., site WDFA key, AH Billing ID, or other approved identifier) where available, the AH Billing ID for the healthcare delivery site is included; otherwise, a site-level WDFA ID is used
  - SHALL always be populated
  - each identifier SHALL always have the associated .system and .type populated
  - .system SHALL use URI from Location Identifier Naming System and SHALL use the associated identifier type code for .type
- Submitting Site Name (extension.entityName.valueString)
- EMR Vendor Name (extension.entityName.valueString)
- EMR Product Name (extension.entityName.valueString)
- Submission IG Type (extension.entityName.valueString)
- Submission IG version (extension.entityName.valueString)
- Service Delivery Site ID (extension.entityIdentifier.valueIdentifier)
  - SHALL be a valid provincially-assigned delivery site identifier (e.g., site WDFA key, AH Billing ID, or other approved identifier) where available, the AH Billing ID for the healthcare delivery site is included; otherwise, a site-level WDFA ID is used
  - SHALL be the same location identified in ProviderRole.location
  - SHALL always be populated
  - SHALL always have the associated .system and .type populated
  - .system SHALL use URI from Location Identifier Naming System and SHALL use the associated identifier type code for .type
- Service Delivery Site Name (extension.entityName.valueString)
- Authoring Provider ID (extension.entityIdentifier.valueIdentifier)
  - The provider’s billing identifier (Practitioner ID) as issued by Alberta Health is the preferred identifier when available. Otherwise, license number or registration number issued by the regulatory college shall be provided. Additionally, Connect Care Practitioner ID may also be provided.
  - SHALL be the same provider identified in Composition.author
  - SHALL always be populated
  - SHALL always have the associated .system, .type, and .value populated
  - .system SHALL use URI from Provider Identifier and License Number Naming System, and SHALL use the associated identifier type code for .type, and the associated assigning authority name for assigner.display
  - .value maximum character length SHALL be 20
extension.entityType.valueCodeableConcept.coding.code identifies the submission metadata (e.g. Submitting Site ID, EMR Vendor Name, etc.)