Ontario eReferral - eConsult HL7® FHIR® Implementation Guide

Mappings

rim: Entity. Role, or Act
rim: ED

id

Σ

0..1

There are no (further) constraints on this element

Element id

Binary.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

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

language

S

0..1

codeBinding

Element id

Binary.language

Short description

Language of the resource content. Currently, only English and French are supported.

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

contentType

S Σ

1..1

codeBinding

Element id

Binary.contentType

Short description

MimeType of the binary content

Definition

MimeType of the binary content represented as a standard MimeType (BCP 13).

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeType (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.mediaType

securityContext

Σ C

0..1

There are no (further) constraints on this element

Element id

Binary.securityContext

Short description

Identifies another resource to use as proxy when enforcing access control

Definition

This element identifies another resource that can be used as a proxy of the security sensitivity to use when deciding and enforcing access control rules for the Binary resource. Given that the Binary resource contains very few elements that can be used to determine the sensitivity of the data and relationships to individuals, the referenced resource stands in as a proxy equivalent for this purpose. This referenced resource may be related to the Binary (e.g. Media, DocumentReference), or may be some non-related Resource purely as a security proxy. E.g. to identify that the binary resource relates to a patient, and access should only be granted to applications that have access to the patient.

Comments

Very often, a server will also know of a resource that references the binary, and can automatically apply the appropriate access rules based on that reference. However, there are some circumstances where this is not appropriate, e.g. the binary is uploaded directly to the server without any linking resource, the binary is referred to from multiple different resources, and/or the binary is content such as an application logo that has less protection than any of the resources that reference it.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

data

S

1..1

There are no (further) constraints on this element

Element id

Binary.data

Short description

The actual content

Definition

The actual content, base64 encoded.

Comments

If the content type is itself base64 encoding, then this will be base64 encoded twice - what is created by un-base64ing the content must be the specified content type.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.data

id

0..1

There are no (further) constraints on this element

Element id

Binary.data.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

Mappings

rim: n/a

extension

C

0..*

Element id

Binary.data.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

http://ehealthontario.ca/fhir/StructureDefinition/ext-attachment-metadata

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

ext-attachment-metadata

S C

0..1

Extension(Complex)

Element id

Binary.data.extension:ext-attachment-metadata

Short description

Attachment Metadata Extension

Alternate names

extensions, user content

Definition

Attachment Metadata 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(Complex)

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

System.String

There are no (further) constraints on this element

Element id

Binary.data.value

Short description

Primitive value for base64Binary

Definition

Primitive value for base64Binary

Data type

System.String

Hybrid View

EReferralBinary (Binary)

There are no (further) constraints on this element

Element id

Binary

Short description

Pure binary content defined by a format other than FHIR

Definition

A resource that represents the data of a single raw artifact as digital content accessible in its native format. A Binary resource can contain any content, whether text, image, pdf, zip archive, etc.

Comments

Typically, Binary resources are used for handling content such as:

CDA Documents (i.e. with XDS)
PDF Documents
Images (the Media resource is preferred for handling images, but not possible when the content is already binary - e.g. XDS).

Data type

Mappings

rim: Entity. Role, or Act
rim: ED

id

Σ

0..1

There are no (further) constraints on this element

Element id

Binary.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

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

language

S

0..1

codeBinding

Element id

Binary.language

Short description

Language of the resource content. Currently, only English and French are supported.

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

contentType

S Σ

1..1

codeBinding

Element id

Binary.contentType

Short description

MimeType of the binary content

Definition

MimeType of the binary content represented as a standard MimeType (BCP 13).

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeType (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.mediaType

securityContext

Σ C

0..1

There are no (further) constraints on this element

Element id

Binary.securityContext

Short description

Identifies another resource to use as proxy when enforcing access control

Definition

This element identifies another resource that can be used as a proxy of the security sensitivity to use when deciding and enforcing access control rules for the Binary resource. Given that the Binary resource contains very few elements that can be used to determine the sensitivity of the data and relationships to individuals, the referenced resource stands in as a proxy equivalent for this purpose. This referenced resource may be related to the Binary (e.g. Media, DocumentReference), or may be some non-related Resource purely as a security proxy. E.g. to identify that the binary resource relates to a patient, and access should only be granted to applications that have access to the patient.

Comments

Very often, a server will also know of a resource that references the binary, and can automatically apply the appropriate access rules based on that reference. However, there are some circumstances where this is not appropriate, e.g. the binary is uploaded directly to the server without any linking resource, the binary is referred to from multiple different resources, and/or the binary is content such as an application logo that has less protection than any of the resources that reference it.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

data

S

1..1

There are no (further) constraints on this element

Element id

Binary.data

Short description

The actual content

Definition

The actual content, base64 encoded.

Comments

If the content type is itself base64 encoding, then this will be base64 encoded twice - what is created by un-base64ing the content must be the specified content type.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.data

id

0..1

There are no (further) constraints on this element

Element id

Binary.data.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

Mappings

rim: n/a

extension

C

0..*

Element id

Binary.data.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

http://ehealthontario.ca/fhir/StructureDefinition/ext-attachment-metadata

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

ext-attachment-metadata

S C

0..1

Extension(Complex)

Element id

Binary.data.extension:ext-attachment-metadata

Short description

Attachment Metadata Extension

Alternate names

extensions, user content

Definition

Attachment Metadata 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(Complex)

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

System.String

There are no (further) constraints on this element

Element id

Binary.data.value

Short description

Primitive value for base64Binary

Definition

Primitive value for base64Binary

Data type

System.String

Snapshot View

EReferralBinary (Binary)

There are no (further) constraints on this element

Element id

Binary

Short description

Pure binary content defined by a format other than FHIR

Definition

A resource that represents the data of a single raw artifact as digital content accessible in its native format. A Binary resource can contain any content, whether text, image, pdf, zip archive, etc.

Comments

Typically, Binary resources are used for handling content such as:

CDA Documents (i.e. with XDS)
PDF Documents
Images (the Media resource is preferred for handling images, but not possible when the content is already binary - e.g. XDS).

Data type

Mappings

rim: Entity. Role, or Act
rim: ED

id

Σ

0..1

There are no (further) constraints on this element

Element id

Binary.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

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

Binary.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

language

S

0..1

codeBinding

Element id

Binary.language

Short description

Language of the resource content. Currently, only English and French are supported.

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a

contentType

S Σ

1..1

codeBinding

Element id

Binary.contentType

Short description

MimeType of the binary content

Definition

MimeType of the binary content represented as a standard MimeType (BCP 13).

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeType (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.mediaType

securityContext

Σ C

0..1

There are no (further) constraints on this element

Element id

Binary.securityContext

Short description

Identifies another resource to use as proxy when enforcing access control

Definition

This element identifies another resource that can be used as a proxy of the security sensitivity to use when deciding and enforcing access control rules for the Binary resource. Given that the Binary resource contains very few elements that can be used to determine the sensitivity of the data and relationships to individuals, the referenced resource stands in as a proxy equivalent for this purpose. This referenced resource may be related to the Binary (e.g. Media, DocumentReference), or may be some non-related Resource purely as a security proxy. E.g. to identify that the binary resource relates to a patient, and access should only be granted to applications that have access to the patient.

Comments

Very often, a server will also know of a resource that references the binary, and can automatically apply the appropriate access rules based on that reference. However, there are some circumstances where this is not appropriate, e.g. the binary is uploaded directly to the server without any linking resource, the binary is referred to from multiple different resources, and/or the binary is content such as an application logo that has less protection than any of the resources that reference it.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

data

S

1..1

There are no (further) constraints on this element

Element id

Binary.data

Short description

The actual content

Definition

The actual content, base64 encoded.

Comments

If the content type is itself base64 encoding, then this will be base64 encoded twice - what is created by un-base64ing the content must be the specified content type.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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

Mappings

rim: n/a
rim: ED.data

id

0..1

There are no (further) constraints on this element

Element id

Binary.data.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

Mappings

rim: n/a

extension

C

0..*

Element id

Binary.data.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