Ontario Health
Ontario Clinical Report Exchange Implementation Guide v1.0.0 - Trial Use
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  • Technical Context
    • Technical Context
    • Implementer Responsibility
    • Conformance Rules
    • Connectivity Summary
  • FHIR Artifacts
    • FHIR Artifacts
    • Interactions
    • Profiles
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    • Capability Statement
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  • Change Log
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    1. Index
    2. FHIR Artifacts
    3. Profiles
    4. Binary

For a full list of available versions, see the Directory of published versions

4.2.1. Binary

This profile is directly based on FHIR Binary resource, ensuring seamless compatibility with standardized patient record structures without further restrictions.

Simplifier project page: Binary EHR

Derived from: Binary (R4)

Derived from: Binary

Simplifier project page: EHR Binary Profile

Derived from: Binary (R4)

Canonical_Url Profile_Status Profile_Version FHIR_Version

4.2.1.1. Usage

The binary resource captures the base64Encoded data in the document such as Text, PDF, image, etc. If they are present, they will be part of Composition.section.entry.

4.2.1.2. Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Differential View

BinaryEHR (Binary)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

Binary

Mappings
  • rim: Entity. Role, or Act
  • rim: ED
idΣ0..1id
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

id

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
metaΣ0..1Meta
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

Meta

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
implicitRulesΣ ?!0..1uri
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

uri

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
languageS0..1codeBindingElement id
Binary.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.

LanguageEHR (required)

Binding extensions
MaxValueSetAllLanguages
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
contentTypeS Σ1..1codeBindingElement 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

code

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeTypeEHR (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
securityContextΣ C0..1Reference(Resource)
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

Reference(Resource)

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
dataS1..1base64Binary
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

base64Binary

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
id0..1string
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

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement 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

Extension

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-metadataS C0..1Extension(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

AttachmentMetadata

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
value0..1System.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

BinaryEHR (Binary)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

Binary

Mappings
  • rim: Entity. Role, or Act
  • rim: ED
idΣ0..1id
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

id

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
metaΣ0..1Meta
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

Meta

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
implicitRulesΣ ?!0..1uri
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

uri

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
languageS0..1codeBindingElement id
Binary.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.

LanguageEHR (required)

Binding extensions
MaxValueSetAllLanguages
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
contentTypeS Σ1..1codeBindingElement 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

code

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeTypeEHR (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
securityContextΣ C0..1Reference(Resource)
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

Reference(Resource)

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
dataS1..1base64Binary
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

base64Binary

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
id0..1string
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

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement 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

Extension

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-metadataS C0..1Extension(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

AttachmentMetadata

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
value0..1System.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

BinaryEHR (Binary)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

Binary

Mappings
  • rim: Entity. Role, or Act
  • rim: ED
idΣ0..1id
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

id

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
metaΣ0..1Meta
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

Meta

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
implicitRulesΣ ?!0..1uri
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

uri

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
languageS0..1codeBindingElement id
Binary.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.

LanguageEHR (required)

Binding extensions
MaxValueSetAllLanguages
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
contentTypeS Σ1..1codeBindingElement 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

code

Binding

Attachment mime type supported by Ontario Health interfaces.

MimeTypeEHR (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
securityContextΣ C0..1Reference(Resource)
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

Reference(Resource)

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
dataS1..1base64Binary
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

base64Binary

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
id0..1string
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

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement 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

Extension

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-metadataS C0..1Extension(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

AttachmentMetadata

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
value0..1System.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

Table View

Binary..
Binary.language..
Binary.contentType..
Binary.data1..
Binary.data.extension..
Binary.data.extension:ext-attachment-metadataExtension0..1

JSON View

{
"resourceType": "StructureDefinition",
"id": "structuredefinition-binary",
"url": "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-binary",
"version": "1.0.0",
"name": "BinaryEHR",
"title": "Binary EHR",
"status": "active",
"date": "2025-06-06T16:31:10.0976344+00:00",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "Binary",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Binary",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Binary.language",
"path": "Binary.language",
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://ehealthontario.ca/fhir/ValueSet/human-language"
}
},
{
"id": "Binary.contentType",
"path": "Binary.contentType",
"mustSupport": true,
"binding": {
"strength": "required",
"description": "Attachment mime type supported by Ontario Health interfaces.",
"valueSet": "http://ontariohealth.ca/fhir/ehr/ValueSet/mime-type"
}
},
{
"id": "Binary.data",
"path": "Binary.data",
"min": 1,
"mustSupport": true
},
{
"id": "Binary.data.extension",
"path": "Binary.data.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "Binary.data.extension:ext-attachment-metadata",
"path": "Binary.data.extension",
"sliceName": "ext-attachment-metadata",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://ontariohealth.ca/fhir/ehr/StructureDefinition/ext-attachment-metadata"
]
}
],
"mustSupport": true
}
]
}
}

4.2.1.3. Notes

.contentType

  • SHALL contain a MIME code indicating a type of the binary content, e.g. PDF, jpg, tiff, etc.

.data

  • SHALL contain a reference to the report file in the AttachmentMetadata extension
    • SHALL NOT contain the embedded base64encoded content of the report as an attachment

.data.extension

  • For all attachments, the AttachmentMetadata extension on .data will be populated instead of an actual embedded base64Binary. Point of service systems (e.g. EMRs) SHALL follow the Download Attachment flow to download an attachment.

4.2.1.4. Terminology Bindings

PathConformanceValueSet
Binary.languagerequiredhttp://ehealthontario.ca/fhir/ValueSet/human-language
Binary.contentTyperequiredhttp://ontariohealth.ca/fhir/ehr/ValueSet/mime-type

Version: 1.0.0 FHIR Version: R4.0.1

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