GP Connect Send Document

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.
This version of GP Connect Send Document supports one use-case which is a Consultation Summary (PDF).
Additional use-cases are expected to be supported in 2023.

Profile: ITK-MessageHeader-2

ITKMessageHandlingI1..1Extension(Complex)
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..0boolean
referenceΣ I1..1string
identifierΣ0..1Identifier
displayΣ0..1string
referenceΣ I1..1string
identifierΣ0..1Identifier
displayΣ0..1string
timestampΣ1..1instant
nameΣ0..0string
softwareΣ0..0string
versionΣ0..0string
endpointΣ1..1uri
identifierΣ1..1id
codeΣ1..1codeBinding
referenceΣ I1..1string
identifierΣ0..1Identifier
displayΣ0..1string
referenceΣ I1..1string
identifierΣ0..1Identifier
displayΣ0..1string
MessageHeader
DefinitionThe header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle.
Cardinality0...*
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.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
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • v2:MSH / MSA / ERR
  • rim:Message
  • w5:infrastructure.exchange
MessageHeader.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

Common Languages (extensible)
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).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
MessageHeader.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Mappings
  • rim:Entity. Role, or Act
  • rim:N/A
MessageHeader.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.extension:ITKMessageHandling
DefinitionOptional Extension Element - found in all resources.
Cardinality1...1
TypeExtension(Complex)
Aliasextensions, user content
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.event
DefinitionCode that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://hl7.org/fhir/message-events".
Cardinality1...1
TypeCoding
Binding

A set of codes to classify the type of event.

ITK Message Event (extensible)
SummaryTrue
Requirements

Drives the behavior associated with this message.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
  • v2:MSH-9.2
  • rim:./payload[classCode="CACT" and moodCode="EVN" and isNormalAct()]/code[isNormalDatatype()]/code
  • w5:what
MessageHeader.event.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.event.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.event.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

https://fhir.nhs.uk/STU3/CodeSystem/ITK-MessageEvent-2

Mappings
  • rim:n/a
  • v2:C*E.3
  • rim:./codeSystem
  • orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MessageHeader.event.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.7
  • rim:./codeSystemVersion
  • orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MessageHeader.event.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.1
  • rim:./code
  • orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MessageHeader.event.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.2 - but note this is not well followed
  • rim:CV.displayName
  • orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MessageHeader.event.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:Sometimes implied by being first
  • rim:CD.codingRationale
  • orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MessageHeader.destination
DefinitionThe destination application which the message is intended for.
Cardinality0...0
TypeBackboneElement
SummaryTrue
Requirements

Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

Comments

There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:./communicationFunction[typeCode="RCV"]
  • w5:who.focus
MessageHeader.destination.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.destination.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.destination.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.destination.name
DefinitionHuman-readable name for the target system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

May be used for routing of response and/or to support audit.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSH-5
  • rim:unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]/name[type='ST' and isNormalDatatype()])
MessageHeader.destination.target
DefinitionIdentifies the target end system in situations where the initial message transmission is to an intermediary system.
Cardinality0...1
TypeReference(ITK Device)
SummaryTrue
Requirements

Supports multi-hop routing.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]
MessageHeader.destination.target.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.destination.target.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.destination.target.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.destination.target.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.destination.target.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.destination.endpoint
DefinitionIndicates where the message should be routed to.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Identifies where to route the message.

Comments

The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSH-25 (or MSH-6)
  • rim:./telecom
MessageHeader.receiver
DefinitionAllows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.
Cardinality0...1
TypeReference(CareConnect-ITK-Header-Practitioner-1 | CareConnect-ITK-Header-Organization-1)
SummaryTrue
Requirements

Allows routing beyond just the application level.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR'
  • rim:Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText
  • w5:who.focus
MessageHeader.receiver.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.receiver.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.receiver.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.receiver.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.receiver.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.sender
DefinitionIdentifies the sending system to allow the use of a trust relationship.
Cardinality1...1
TypeReference(CareConnect-ITK-Header-Practitioner-1 | CareConnect-ITK-Header-Organization-1)
SummaryTrue
Requirements

Allows routing beyond just the application level.

Comments

Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR'
  • rim:Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText
  • w5:who.focus
MessageHeader.sender.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.sender.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.sender.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.sender.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.sender.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.timestamp
DefinitionThe time that the message was sent.
Cardinality1...1
Typeinstant
SummaryTrue
Requirements

Allows limited detection of out-of-order and delayed transmission. Also supports audit.

Comments

Note: This is intended for precisely observed times, typically system logs etc., and not human-reported times - for them, see date and dateTime below. Time zone is always required

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSH-7
  • rim:./creationTime[isNormalDatatype()]
  • w5:when.init
MessageHeader.enterer
DefinitionThe person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions.
Cardinality0...0
TypeReference(CareConnect-ITK-Header-Practitioner-1)
SummaryTrue
Requirements

Need to know for audit/traceback requirements and possibly for authorization.

Comments

Usually only for the request, but can be used in a response.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:EVN-5 / ORC-10 / PRT-5:PRT-4='EP' / ROL where ROL.3 is EP or ORC.10
  • rim:unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="ENT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  • w5:who.author
MessageHeader.enterer.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.enterer.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.enterer.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.enterer.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.enterer.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.author
DefinitionThe logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions.
Cardinality0...0
TypeReference(CareConnect-ITK-Header-Practitioner-1)
SummaryTrue
Requirements

Need to know for audit/traceback requirements and possibly for authorization.

Comments

Usually only for the request, but can be used in a response.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ORC-19 / PRT-5:PRT-4='AUT' / ROL where ROL.3 is IP or ORC.12
  • rim:unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="AUT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  • w5:who.author
MessageHeader.author.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.author.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.author.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.author.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.author.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.source
DefinitionThe source application from which this message originated.
Cardinality1...1
TypeBackboneElement
SummaryTrue
Requirements

Allows replies, supports audit.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:unique(./communicationFunction[typeCode="SND"])
  • w5:who.actor
MessageHeader.source.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.source.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.source.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.source.name
DefinitionHuman-readable name for the source system.
Cardinality0...0
Typestring
SummaryTrue
Requirements

May be used to support audit.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSH-3
  • rim:unique(./entity[determinerCode="INST" and classCode="DEV"]/name[type='ST' and isNormalDatatype()])
MessageHeader.source.software
DefinitionMay include configuration or other information useful in debugging.
Cardinality0...0
Typestring
SummaryTrue
Requirements

Supports audit and possibly interface engine behavior.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:SFT-3 ( +SFT-1)
  • rim:unique(./entity[determinerCode="INST" and classCode="DEV"]/softwareName[isNormalDatatype()])
MessageHeader.source.version
DefinitionCan convey versions of multiple systems in situations where a message passes through multiple hands.
Cardinality0...0
Typestring
SummaryTrue
Requirements

Supports audit and possibly interface engine behavior.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:SFT-2
  • rim:(Not supported)
MessageHeader.source.contact
DefinitionAn e-mail, phone, website or other contact point to use to resolve issues with message communications.
Cardinality0...0
TypeContactPoint
SummaryTrue
Requirements

Allows escalation of technical issues.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • cpt-2:A system is required if a value is provided.
    value.empty() or system.exists()
Mappings
  • rim:n/a
  • v2:XTN
  • rim:TEL
  • servd:ContactPoint
  • v2:(MSH-22?)
  • rim:unique(./entity[determinerCode="INST" and classCode="DEV"]/scopesRole[normalRole() and classCode="CON" and layer[classCode="PSN"]/telecom[isNormalDatatype()])
MessageHeader.source.contact.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.source.contact.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.source.contact.system
DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact.
Cardinality1...1
Typecode
Binding

Telecommunications form for contact point

ContactPointSystem (required)
SummaryTrue
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:XTN.3
  • rim:./scheme
  • servd:./ContactPointType
MessageHeader.source.contact.value
DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:XTN.1 (or XTN.12)
  • rim:./url
  • servd:./Value
MessageHeader.source.contact.use
DefinitionIdentifies the purpose for the contact point.
Cardinality0...1
Typecode
Binding

Use of contact point

ContactPointUse (required)
ModifierTrue
SummaryTrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:XTN.2 - but often indicated by field
  • rim:unique(./use)
  • servd:./ContactPointPurpose
MessageHeader.source.contact.rank
DefinitionSpecifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.
Cardinality0...1
TypepositiveInt
SummaryTrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:n/a
MessageHeader.source.contact.period
DefinitionTime period when the contact point was/is in use.
Cardinality0...1
TypePeriod
SummaryTrue
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2:N/A
  • rim:./usablePeriod[type="IVL<TS>"]
  • servd:./StartDate and ./EndDate
MessageHeader.source.endpoint
DefinitionIdentifies the routing target to send acknowledgements to.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Identifies where to send responses, may influence security permissions.

Comments

The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSH-24
  • rim:./telecom[isNormalDatatype()]
MessageHeader.responsible
DefinitionThe person or organization that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party.
Cardinality0...0
TypeReference(CareConnect-ITK-Header-Practitioner-1 | CareConnect-ITK-Header-Organization-1)
SummaryTrue
Requirements

Need to know for audit/traceback requirements and possibly for authorization.

Comments

Usually only for the request, but can be used in a response.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ORC-12 / PRT-5:PRT-4='OP' / PRT-8:PRT-4='OP' / ROL where ROL.3 is RO or ORC.11
  • rim:unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode="PSN" and determinerCode="INST"] or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/scoper[isNormalEntity() and classCode="ORG" and determinerCode="INST"])
  • w5:who.witness
MessageHeader.responsible.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.responsible.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.responsible.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.responsible.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.responsible.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.reason
DefinitionCoded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message.
Cardinality0...0
TypeCodeableConcept
Binding

Reason for event occurrence

Example Message Reason Codes (example)
SummaryTrue
Requirements

Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:EVN.4 / ORC.16 / OBR-31-reason for study / BPO-13-BP indication for use / RXO-20-indication / RXE-27-give indication / RXD-21-indication / RXG-22-indication / RXA-19-indication
  • rim:unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/reasonCode[isNormalDatatype()])
  • w5:why
MessageHeader.reason.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.reason.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.reason.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
  • v2:C*E.1-8, C*E.10-22
  • rim:union(., ./translation)
  • orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MessageHeader.reason.coding.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.reason.coding.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.reason.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.3
  • rim:./codeSystem
  • orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MessageHeader.reason.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.7
  • rim:./codeSystemVersion
  • orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MessageHeader.reason.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.1
  • rim:./code
  • orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MessageHeader.reason.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.2 - but note this is not well followed
  • rim:CV.displayName
  • orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MessageHeader.reason.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:Sometimes implied by being first
  • rim:CD.codingRationale
  • orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MessageHeader.reason.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.9. But note many systems use C*E.2 for this
  • rim:./originalText[mediaType/code="text/plain"]/data
  • orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MessageHeader.response
DefinitionInformation about the message that this message is a response to. Only present if this message is a response.
Cardinality0...1
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSA
  • rim:./conveyedAcknowledgement
MessageHeader.response.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.response.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.response.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.response.identifier
DefinitionThe MessageHeader.id of the message to which this message is a response.
Cardinality1...1
Typeid
SummaryTrue
Requirements

Allows receiver to know what message is being responded to.

Comments

RFC 4122

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSA-2
  • rim:./acknowledges.id[isNormalDatatype()]
MessageHeader.response.code
DefinitionCode that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not.
Cardinality1...1
Typecode
Binding

The kind of response to a message

ResponseType (required)
SummaryTrue
Requirements

Allows the sender of the acknowledge message to know if the request was successful or if action is needed.

Comments

This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:MSA-1
  • rim:./typeCode[isNormalDatatype()]
MessageHeader.response.details
DefinitionFull details of any issues found in the message.
Cardinality1...1
TypeReference(ITK-Response-OperationOutcome-1)
SummaryTrue
Requirements

Allows the sender of the message to determine what the specific issues are.

Comments

This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:ERR
  • rim:AcknowledgementDetail or Observation[classCode="ALRT" and moodCode="EVN"]
MessageHeader.response.details.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.response.details.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.response.details.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.response.details.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.response.details.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.focus
DefinitionThe actual data of the message - a reference to the root/focus class of the event.
Cardinality0...1
TypeReference(Resource)
SummaryTrue
Requirements

Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources.

Comments

The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="SUBJ" and isNormalParticipation]/role or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/outboundRelationship[typeCode="SBJ" and isNormalActRelatoinship]/target)
MessageHeader.focus.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MessageHeader.focus.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
MessageHeader.focus.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MessageHeader.focus.identifier
DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • rim:.identifier
MessageHeader.focus.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A

Elements required for capability

Element Use CareConnect UK Core
id
meta.profile
meta.versionId
meta.lastUpdated
extension(ITKMessageHandling)
event
receiver
sender
timestamp
source
response
focus

id

Usage

Optional

Guidance

The id is the logical identifier for the ITK-MessageHeader-2 profile.

Example
<id value="93f82adc-5ab9-11ed-9b6a-0242ac120002" />


meta.versionId

Usage

Optional

Guidance

The meta.versionId element does not need to be populated.

Example
<meta>
    <versionId value="1" />
</meta>


meta.lastUpdated

Usage

Optional

Guidance

The meta.lastUpdated element does not need to be populated.

Example
<meta>
    <lastUpdated value="2022-11-02T14:19:00+00:00" />
</meta>


meta.profile

Usage

Mandatory

Guidance

The meta.profile contains a fixed value of the URL for the ITK-MessageHeader-2 profile.

Example
<meta>
    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/ITK-MessageHeader-2" />
</meta>


meta.security

Usage

Optional

Guidance

The meta.security element does not need to be populated.

Example
<meta>
    <security>
        <coding>
            <system value="http://hl7.org/fhir/v3/Confidentiality" />
            <code value="L" />
            <display value="low" />
        </coding>
    </security>
</meta>


meta.tag

Usage

Optional

Guidance

The meta.tag element does not need to be populated for this capability.

Example
<meta>
    <tag>
        <coding>
            <system value="http://hl7.org/fhir/common-tags" />
            <code value="actionable" />
            <display value="Actionable" />
        </coding>
    </tag>
</meta>


extension(ITKMessageHandling)

Usage

Mandatory

Guidance

This item is found in the Extension-ITK-MessageHandling-2 extension within the ITK3 Message Header. More information about how to populate this element can be found in this guide using the link below.

Extension: Extension-ITK-MessageHandling-2


event

Usage

Mandatory

Guidance

Sender

The ITK-MessageHeader-2.event MUST contain a fixed value of ITK007C (ITK GP Connect Send Document) from the code system ITK-MessageEvent-2.

ITK3 responses generated

The event MUST contain a fixed value of ITK008M from the code system ITK-MessageEvent-2.

Example
<event>
   <system value="https://fhir.nhs.uk/STU3/CodeSystem/ITK-MessageEvent-2"/>
   <code value="ITK007C"/>
   <display value="ITK GP Connect Send Document"/>
</event>


receiver

Usage

Optional

Guidance
Note: This only applies if your organisation is using MESH for message routing. If your organisation is using FHIR, then this element must be populated. Guidance on how to populate this will be provided in a future version of this implementation guide.

This value DOES NOT need to be present. The Send Document capability currently relies on MESH message routing to be used to route the message to the registered GP practice using a citizen's:

  • NHS Number
  • date of birth
  • surname

sender

Usage

Mandatory

Guidance

Sender

A reference MUST be provided using the CareConnect-Organization-1 resource.

ITK3 responses generated

A reference MUST contain a reference to an CareConnect-Organization-1 resource present in the FHIR message bundle.

More information about how to populate this resource can be found in this guide using the link below.


timestamp

Usage

Mandatory

Guidance

The timestamp element MUST contain the date and time of when the message was generated.

Note: A separate process such as the MESH client may be responsible for sending the message at a later date/time.

source

Usage

Mandatory

Guidance

The source element MUST contain the MESH mailbox ID of the sender.

Example
<source>
    <endpoint value="MESHGP0001" />
</source>


response

Usage

Optional.

Guidance

Not required to be populated as this use case assumes communication is linear between the sender and receiver.


focus

Usage

Mandatory

Guidance

A reference MUST be provided using the ITK-Document-Bundle-1 resource.

More information about how to populate this resource can be found in this guide using the link below.

Profile: ITK-Document-Bundle-1

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