Akteure

Dokumentenserver

Das bestätigungsrelevante System nimmt die Rolle des Dokumentenservers ein. Ein Dokumentenserver nimmt Dokumente von Clients zur Speicherung/Archivierung/Verwaltung entgegen und erlaubt Clients die Suche nach und den Abruf von Dokumenten.

Dieses ISiK-Modul legt fest, welche Suchkriterien mindestens implementiert werden müssen und welche Kriterien darüber hinaus optional bereitgestellt werden können. Um Clients die Herstellung von Patienten- und Encounterkontext zu ermöglichen, müssen weiterhin die im Basismodul Stufe 4 festgelegten Interaktionen auf den Datenobjekten "Patient" und "Kontakt/Fall (Encounter)" implementiert werden.

Der Dokumentenserver nimmt im IHE-MHD-Kontext die Rollen Document Recipient und Document Responder ein und implementiert die IHE-MHD-Interaktionen

• Simplified Publish [ITI-105] (verpflichtend)
• Generate Metadata [ITI-106] (optional)
• Find Document References [ITI-67] (verpflichtend)
• Retrieve Document [ITI-68] (verpflichtend)

(Webbasierter/Mobiler) Client

Clients können Dokumente von einem Dokumentenserver abfragen, um sie z.B. einem Anwender anzuzeigen. Dabei können sie die für die Server verpflichtend festgelegten Suchkriterien beliebig kombinieren. Clients sind nicht verpflichtet, alle von den Servern geforderten Suchkriterien zu unterstützen. Weiterhin können Clients neu erstellte, geänderte oder erweiterte Dokumente an einen Dokumentenserver übermitteln. Dabei müssen sie jedoch mindestens die in diesem Modul verpflichtend festgelegten Metadaten zu den Dokumenten bereitstellen. Sowohl die Implementierung der Interaktion "Dokumentenabfrage" als auch "Dokumentenbereitstellung" sind für Clients optional.

Der Client nimmt im IHE-MHD-Kontext die Rollen Document Source und Document Consumer ein und implementiert die IHE-MHD-Interaktionen

• Simplified Publish [ITI-105] (optional)
• Generate Metadata [ITI-106] (optional)
• Find Document References [ITI-67] (optional)
• Retrieve Document [ITI-68] (optional)

Interaktionen

Dokumentenabfrage und -Zugriff (bestätigungsrelevant)

Use Case: Ein (webbasierter/mobiler) Client möchte Dokumente anhand definierter Kriterien abfragen. Zur Dokumenten(-Metadaten)abfrage nutzt diese Spezifikation die SEARCH-Interaktionen auf der DocumentReference-Ressource gemäß der FHIR-Spezifikation. Dabei MÜSSEN ausgewählte Suchparameter von Dokumentenservern verpflichtend unterstützt werden. Die Selektion erfolgt anhand der Relevanz der Parameter für die identifizierten Use Cases.

Der Zugriff auf die von den DocumentReferences verlinkten Dokumente (z.B. im PDF-Format) MUSS per READ-Interaktion auf der Binary-Ressource gemäß ISIK-Spezifikation erfolgen.

Dokumentenbereitstellung (bestätigungsrelevant)

Use Case: Ein (webbasierter/mobiler) Client möchte neu erstellte, geänderte oder erweiterte Dokumente an einen Dokumentenserver übermitteln. Der Server MUSS Dokument und Metadaten entgegennehmen, diese persistieren und anschließend für die Dokumentabfrage und den -zugriff bereitstellen.

Update von Dokumentenmetadaten (optional)

Use Case: Ein Client möchte die Metadaten eines Dokumentes ändern, ohne den Inhalt des Dokumentes selbst zu beeinflussen oder eine neue Version des Dokumentes hochladen zu müssen. Dies ist nur für eine stark eingeschränkte Menge von Elementen möglich. Der Server stellt dafür eine Operation zur Verfügung, deren Parameter den änderbaren Elementen entsprechen.

Erzeugen von Dokumentenmetadaten (optional)

Use Case: Ein Client möchte ein gem. ISiK Basismodul erzeugtes, strukturiertes, FHIR-basiertes Dokument an einen Dokumentenserver übermitteln. Der Server stellt dazu eine Operation zur Verfügung, die aus den strukturierten Daten des Dokumentes die erforderlichen Metadaten extrahiert und dem Client eine entsprechend ausgefüllte DocumentReference-Ressource zurückgibt. Diese Operation kann von einem Dokumentenserver aber auch einem Drittsystem bereitgestellt werden.

Interaktion: Dokumentenbereitstellung

Dokumentenübermittlung (IHE MHD ITI-105 (Simplified Publish))

Die Dokumentenübermittlung erfolgt mittels IHE MHD ITI-105 (Simplified Publish)

Die Übermittlung des Dokumentes vom Client an den Server erfolgt mittels einer CREATE-Interaktion auf dem Ressourcentyp DocumentReference. Das anzulegende Dokument wird im Body der Interaktion übermittelt. Es gelten die Vorgaben der FHIR-Kernspezifikation für den Rückgabewert der Create-Interaktion, siehe Managing Return Content.

Hinweise und Anmerkungen zur Implementierung von ITI-105 (Simplified Publish) im Kontext von ISiK

Für die Implementierung der Interaktion "Dokumentenbereitstellung" gelten die in IHE MHD festgelegten Vereinbarungen zu ITI-105 gemäß der unten aufgelisteten Kapitel. Abweichungen bzw. zusätzliche Festlegungen im Kontext von ISiK sind im Folgenden zu den einzelnen Kapiteln vermerkt.

2:3.105.4.1 Simplified Publish Request Message

2:3.105.4.1.1 Trigger Events

Die Vereinbarungen gelten uneingeschränkt.

2:3.105.4.1.2 Message Semantics

• Die übermittelte Ressource muss nur gegen das Profil "ISiKDokumentenMetadaten" valide sein, nicht gegen die IHE-DocumentReference-Profile, da die Übermittlung des Elementes DocumentReference.docStatus im ISiK-Kontext erlaubt, im IHE-Kontext jedoch verboten ist.
• Für Clients ist es ausreichend, das Dokument mit Hilfe eines KDL-Codes in DocumentReference.type zu klassifizieren. Die entsprechenden XDS-Class- und -Type-Codes müssen vom Server bei der Verarbeitung ergänzt werden. DocumentReference.category kann bei der Dokumentenbereitstellung leer bleiben.

2:3.105.4.1.2.1 DocumentReference Resources

• Die DocumentReference-Ressoucen müssen im ISiK-Kontext auf Basis des Profils "ISiKDokumentenMetadaten" und den dort vereinbarten Kardinalitäten bzw. MustSupport-Flags erstellt werden.
• Die Verwendung von Contained-Ressourcen ist im ISiK-Kontext nicht erlaubt

2:3.105.4.1.2.2 Patient Identity

• Der Client MUSS eine der im Kapitel "Herstellung von Patient- und Enocunterkontext" beschriebenen Optionen verwenden, um den Patienten- und Encounter-Kontext zu etablieren.
• Logische Referenzen für Patient und Encounter sind im ISiK-Kontext nicht erlaubt
• DocumentReference.sourcePatientInfo wird im ISiK-Kontext nicht verwendet

2:3.105.4.1.2.3 Replace, Transform, Signs, and Append Associations

Die Vereinbarungen gelten uneingeschränkt.

Hinweis: Dies bedeutet, dass inhaltliche Updates von Dokumenten, in Abgrenzung zu Updates von Dokumentenmetadaten, durch den Client als neue Create-Interaktion durchgeführt werden muss. Update-Interaktionen sind in diesem Kontext undefiniert. Das Dokument, welches das Update repräsentiert, muss eine entsprechende relatesTo-Relation zum vorherigen Dokument aufweisen. Der Status des vorherigen Dokumentes MUSS durch den Server auf superseded gesetzt werden.

2:3.105.4.1.3 Expected Actions

• Die Erzeugung einer SubmissionSet Ressource durch den Server ist im ISiK-Kontext nicht erforderlich.
• Der Server muss ggf. fehlende XDS-Class- und -Type-Codes anhand des übermittelten KDL-Codes ergänzen und in DocumentReference.type bzw. DocumentReference.category zurückliefern. Die XDS-Codes können über die im Rahmen der KDL-Spezifikation publizierten ConceptMaps aus dem KDL-Code ermittelt werden. Die XDS-Codes werden für den einrichtungsübergreifenden Dokumentenaustausch über IHE XDS, bzw. MHD oder für die Übermittlung der Dokumente an die ePA des Patienten benötigt.

2:3.105.4.1.3.1 Grouping with Actors in other Document Sharing Profiles

Das Kapitel ist für den ISiK-Kontext nicht relevant.

2:3.105.4.2 Simplified Publish Response Message

2:3.105.4.2.1 Trigger Events

Die Vereinbarungen gelten uneingeschränkt.

2:3.105.4.2.2 Message Semantics

Die Vereinbarungen gelten uneingeschränkt.

2:3.105.4.2.3 Expected Actions

Die Vereinbarungen gelten uneingeschränkt.

2:3.105.4.3 CapabilityStatement Resource

Es gelten die Vereinbarungen gemäß

2:3.105.5 Security Considerations

Für Hinweise zur Implementierung von Autorisation und Authentifikation im ISiK-Kontext, siehe Modul ISiK-Connect

Herstellung von Patient- und Encounterkontext

Vor der Bereitstellung von Dokumenten muss ein Client einen Patienten- und Encounterkontext herstellen, damit das Dokument serverseitig anhand der Patient- und Encounter-Verlinkungen in der DocumentReference korrekt zugeordnet werden kann. Zur Herstellung des Kontextes sind die in ISiK Basis beschriebenen Verfahren möglich: https://simplifier.net/guide/isik-basis-stufe-5/Einfuehrung/UebergreifendeFestlegungen/Patient-Besuch-Kontext

Zusätzlich kann der Bezug mit Hilfe einer Logischen Referenz hergestellt werden. Dieses Verfahren ist experimentell und derzeit nur auf die Herstellung des Patientenkontextes begrenzt:

Der Client übermittelt in DocumentReference.subject.identifier einen Identifier, über den im Dokumentensystem ein eindeutiger Bezug hergestellt werden kann (z.B. eine einrichtungsinterne PID oder eine Krankenversichertenummer). Das Dokumentensystem (Server) muss dann bei der Verarbeitung den Identifier (unter Berücksichtigung von system und value) auflösen und durch eine Referenz auf die entsprechende lokale Patienten-Ressource substituieren. Typische UseCases hierfür sind u.A.:

• die Konvertierung von HL7 V2 MDM-Nachrichten in eine FHIR-REST-Interaktion
• die Übernahme von Patienten über die kommende REST-basierte Möglichkeit, Dokumente aus der ePA eines Patienten abzurufen (auch hier werden voraussichtlich ausschließlich DocumentReference-Ressourcen mit der Versichertennummer als logischer Referenz auf den Patienten bereitgestellt)

Server, die eine Zuordnung von Dokumenten mittels logischer Referenz erlauben, MÜSSEN dies im CapabilityStatement für den Ressourcentyp DocumentReference unter CapabilityStatement.rest.resource.referencePolicy` kenntlich machen:

• Der Code resolves ist zu verwenden wenn logical Identifier erlaubt sind, aber stets auflösbar sein müssen (Trifft ein Identifier aus einen oder mehrere Patienten zu, stellt dies einen Fehlerzustand dar.)
• Der Code logical ist zusätzlich anzugeben, wenn der Server auch DocumentReferences akzeptiert, denen kein Patient zugeordnet werden kann (z.B. in Erwartung, dass dieser zu einem späteren Zeitpunkt ergänzt wird).
• Clients sind verpflichtet vor der Verwendung von DocumentReferences mit logischen Referenzen anhand des CapabilityStatements zu überprüfen, ob ein konkreter Server diese Funktionalität unterstützt.

Weitere Hinweise siehe https://hl7.org/fhir/R4/references.html#logical

Hinweis	Experimentelle Funktion
	Die Zuordnung mittels logischer Identifier ist bisher nicht erprobt. Entwickler, die diese Funktionalität nutzen, sind gebeten, im Chat ein Feedback zu hinterlassen, ob sich diese Funktion implementierbar/nützlich oder komplex/problematisch erwiesen hat. Abhängig von der Rückmeldung kann dieses Feature in späteren Releases entweder verbindlich gemacht oder entfernt werden.

Änderungen zwischen ISiK Stufe 2 und ISiK Stufe 3

Hinweis	Breaking Change!
	Die in der Stufe 3 erfolgte Umstellung der Interaktion von der $submit-document-Operation auf eine REST-basierte CREATE-Interaktion ist nicht kompatibel zu den Festlegungen dieses Moduls in Stufe 2! Die Änderung dient dem Zweck der Harmonisierung mit der IHE-MHD-Interaktion ITI-105 (Simplified Publish), die zum Zeitpunkt des Releases von Stufe 2 noch nicht zur Verfügung stand.

Maßgebliche Änderungen gegenüber Stufe 2 für den Client

• Der Client muss das eigentliche Dokument (PDF, JPEG o.ä.) base64-codiert in DocumentReference.content.attachment.data einbetten und den Mime-Type des Dokumentes in DocumentReference.content.attachment.contentType adäquat setzen
• Die Übermittlung erfolgt mittels POST auf den Endpunkt [base]/DocumentReference anstatt wie bisher mittels POST auf den Endpunkt [base]\DocumentReference\$submit-document
• Die DocumentReference-Ressource mit den eingebetteten Binärdaten wird nun unmittelbar im Body der Interaktion gesendet. Die Notwendigkeit, DocumentReference und Binary in eine Parameters-Ressource zu wrappen, entfällt damit.
• Die Antwort des Servers erfolgt in Form einer DocumentReference-Ressource (im Erfolgsfall) bzw. einer OperationOutcome-Ressource im Fehlerfall anstelle wie bisher einer Parameters-Ressource.

Maßgebliche Änderungen gegenüber Stufe 2 für den Server

• Die DocumentReference-Ressource mit den eingebetteten Binärdaten wird nun unmittelbar im Body der Interaktion gesendet. Die Notwendigkeit, DocumentReference und Binary aus der Parameters-Ressource zu extrahieren, entfällt damit.
• Die Übermittlung erfolgt mittels POST auf den Endpunkt [base]/DocumentReference anstatt wie bisher mittels POST auf den Endpunkt [base]\DocumentReference\$submit-document
• Der Server MUSS das eingebettete Dokument aus der DocumentReference herauslösen, separat persistieren und in DocumentReference.content.attachemnt.url auf das separierte Dokument verweisen. Beim Abruf einer DocumentReference, bzw. bei der Suche nach DocumentReference-Ressourcen darf das Dokument niemals eingebettet an den Client zurückgegeben werden. Das Dokument muss über den Binary-Endpunkt der API abrufbar gemacht werden.
• Die Antwort des Servers erfolgt in Form einer DocumentReference-Ressource (im Erfolgsfall) bzw. einer OperationOutcome-Ressource im Fehlerfall anstelle wie bisher einer Parameters-Ressource.

Beispiel

POST [base]/DocumentReference

<DocumentReference xmlns="http://hl7.org/fhir">
    <id value="dok-beispiel-client-with-binary-jpeg-example-short" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKDokumentenMetadaten" />
        <security>
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason" />
            <code value="HTEST" />
        </security>
    </meta>
    <masterIdentifier>
        <system value="urn:ietf:rfc:3986" />
        <value value="urn:oid:1.2.840.113556.1.8000.2554.58783.21864.3474.19410.44358.58254.41281.46340" />
    </masterIdentifier>
    <status value="current" />
    <type>
        <coding>
            <system value="http://dvmd.de/fhir/CodeSystem/kdl" />
            <code value="ED020101" />
            <display value="Fotodokumentation Operation" />
        </coding>
    </type>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <description value="Fotodokumentation Operation vom 31.12.21" />
    <securityLabel>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality" />
            <code value="N" />
        </coding>
    </securityLabel>
    <content>
        <attachment>
            <contentType value="image/jpeg" />
            <language value="de" />
            <data value="4AAQSkZJRgABAQEB" />
            <creation value="2020-12-31T23:50:50-05:00" />
        </attachment>
        <format>
            <system value="http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode" />
            <code value="urn:ihe:iti:xds:2017:mimeTypeSufficient" />
            <display value="mimeType Sufficient" />
        </format>
    </content>
    <context>
        <encounter>
            <reference value="Encounter/FachabteilungskontaktNormal" />
        </encounter>
        <facilityType>
            <coding>
                <system value="http://ihe-d.de/CodeSystems/PatientBezogenenGesundheitsversorgung" />
                <code value="KHS" />
                <display value="Krankenhaus" />
            </coding>
        </facilityType>
        <practiceSetting>
            <coding>
                <system value="http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen" />
                <code value="ALLG" />
            </coding>
        </practiceSetting>
    </context>
</DocumentReference>

{
    "resourceType": "DocumentReference",
    "id": "dok-beispiel-client-with-binary-jpeg-example-short",
    "meta": {
        "security":  [
            {
                "code": "HTEST",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason"
            }
        ],
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKDokumentenMetadaten"
        ]
    },
    "type": {
        "coding":  [
            {
                "system": "http://dvmd.de/fhir/CodeSystem/kdl",
                "code": "ED020101",
                "display": "Fotodokumentation Operation"
            }
        ]
    },
    "masterIdentifier": {
        "system": "urn:ietf:rfc:3986",
        "value": "urn:oid:1.2.840.113556.1.8000.2554.58783.21864.3474.19410.44358.58254.41281.46340"
    },
    "status": "current",
    "description": "Fotodokumentation Operation vom 31.12.21",
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "securityLabel":  [
        {
            "coding":  [
                {
                    "code": "N",
                    "system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality"
                }
            ]
        }
    ],
    "content":  [
        {
            "attachment": {
                "contentType": "image/jpeg",
                "data": "4AAQSkZJRgABAQEB",
                "language": "de",
                "creation": "01/01/2021 04:50:50"
            },
            "format": {
                "code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
                "system": "http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode",
                "display": "mimeType Sufficient"
            }
        }
    ],
    "context": {
        "facilityType": {
            "coding":  [
                {
                    "code": "KHS",
                    "system": "http://ihe-d.de/CodeSystems/PatientBezogenenGesundheitsversorgung",
                    "display": "Krankenhaus"
                }
            ]
        },
        "practiceSetting": {
            "coding":  [
                {
                    "code": "ALLG",
                    "system": "http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen"
                }
            ]
        },
        "encounter":  [
            {
                "reference": "Encounter/FachabteilungskontaktNormal"
            }
        ]
    }
}

Hinweis: Die Binary-Ressourcen sind der Lesbarkeit halber verkürzt dargestellt!

Dokumentenabfrage und -zugriff

Dokumentenabfrage (IHE MHD ITI-67 (Find DocumentReferences))

Dokumente können anhand ihrer Metadaten gesucht werden. Im Rahmen der ISiK-Spezifikation müssen mindestens die im Kapitel Interaktionen mit MUSS gekennzeichneten Suchparameter unterstützt werden. Einzelnen Systemen steht es frei, darüber hinaus weitere FHIR-konforme Suchparameter zu implementieren.

Die Ergebnisse einer Suchanfrage werden in Form eines Bundles zurückgegeben:

Bundle

Bundle.id

Bundle.meta

Bundle.implicitRules

Bundle.language

Bundle.identifier

Bundle.type

searchset

Bundle.timestamp

Bundle.total

Bundle.link

Bundle.link.id

Bundle.link.extension

Bundle.link.modifierExtension

Bundle.link.relation

Bundle.link.url

Bundle.entry

Bundle.entry.id

Bundle.entry.extension

Bundle.entry.modifierExtension

Bundle.entry.link

Bundle.entry.fullUrl

Bundle.entry.resource

Bundle.entry.search

Bundle.entry.search.id

Bundle.entry.search.extension

Bundle.entry.search.modifierExtension

Bundle.entry.search.mode

Bundle.entry.search.score

Bundle.entry.request

Bundle.entry.request.id

Bundle.entry.request.extension

Bundle.entry.request.modifierExtension

Bundle.entry.request.method

Bundle.entry.request.url

Bundle.entry.request.ifNoneMatch

Bundle.entry.request.ifModifiedSince

Bundle.entry.request.ifMatch

Bundle.entry.request.ifNoneExist

Bundle.entry.response

Bundle.entry.response.id

Bundle.entry.response.extension

Bundle.entry.response.modifierExtension

Bundle.entry.response.status

Bundle.entry.response.location

Bundle.entry.response.etag

Bundle.entry.response.lastModified

Bundle.entry.response.outcome

Bundle.entry:DocumentReference

Bundle.entry:DocumentReference.id

Bundle.entry:DocumentReference.extension

Bundle.entry:DocumentReference.modifierExtension

Bundle.entry:DocumentReference.link

Bundle.entry:DocumentReference.fullUrl

Bundle.entry:DocumentReference.resource

Bundle.entry:DocumentReference.search

Bundle.entry:DocumentReference.search.id

Bundle.entry:DocumentReference.search.extension

Bundle.entry:DocumentReference.search.modifierExtension

Bundle.entry:DocumentReference.search.mode

Bundle.entry:DocumentReference.search.score

Bundle.entry:DocumentReference.request

Bundle.entry:DocumentReference.request.id

Bundle.entry:DocumentReference.request.extension

Bundle.entry:DocumentReference.request.modifierExtension

Bundle.entry:DocumentReference.request.method

Bundle.entry:DocumentReference.request.url

Bundle.entry:DocumentReference.request.ifNoneMatch

Bundle.entry:DocumentReference.request.ifModifiedSince

Bundle.entry:DocumentReference.request.ifMatch

Bundle.entry:DocumentReference.request.ifNoneExist

Bundle.entry:DocumentReference.response

Bundle.entry:DocumentReference.response.id

Bundle.entry:DocumentReference.response.extension

Bundle.entry:DocumentReference.response.modifierExtension

Bundle.entry:DocumentReference.response.status

Bundle.entry:DocumentReference.response.location

Bundle.entry:DocumentReference.response.etag

Bundle.entry:DocumentReference.response.lastModified

Bundle.entry:DocumentReference.response.outcome

Bundle.signature

Suchergebnisse können zahlreich sein. Server MÜSSEN daher FHIR-konformes Paging unterstützen. Server KÖNNEN im SearchSet-Bundle auch Ressourcen vom Typ OperationOutcome mit Informationen über die Suchergebnisse zurückgeben. Diese müssen in Bundle.entry.search.mode mit dem Wert outcome gekennzeichnet sein. Die Issues im OperationOutcome dürfen nur dem Schweregrad information oder warning entsprechen. Issues vom Schweregrad error oder fatal sind unzulässig.

Hinweise und Anmerkungen zur Implementierung von IHE MHD ITI-67 (Find DocumentReferences)

Für die Implementierung der Interaktion "Dokumentenabfrage" gelten die in IHE MHD festgelegten Vereinbarungen zu ITI-67 (Find DocumentReferences) gemäß der unten aufgelisteten Kapitel. Abweichungen bzw. zusätzliche Festlegungen im Kontext von ISiK sind im Folgenden zu den einzelnen Kapiteln vermerkt.

2:3.67.4.1 Find Document References Request Message

2:3.67.4.1.1 Trigger Events

Die Vereinbarungen gelten uneingeschränkt.

2:3.67.4.1.2 Message Semantics

Es gelten darüber hinaus die allgemeinen Festlegungen zu Suchparametern gemäß ISiK Basisprofil Stufe

2:3.67.4.1.2.1 Query Search Parameters

Im Rahmen der ISiK-Spezifikation müssen mindestens die im Kapitel Interaktionen mit MUSS gekennzeichneten Suchparameter unterstützt werden. Einzelnen Systemen steht es frei, darüber hinaus weitere FHIR-konforme bzw in IHE MHD geforderte Suchparameter zu implementieren.

Die in IHE bestehende Verpflichtung für Clients, bei jeder Query mindestens einen der Parameter patient oder patient.identifier verwenden zu müssen, besteht im ISiK-Kontext nicht. Patientenübergreifende Suchanfragen sind zulässig.

2:3.67.4.1.2.2 Populating Expected Response Format

Die Vereinbarungen gelten uneingeschränkt.

2:3.67.4.1.3 Expected Actions

Die Vereinbarungen gelten uneingeschränkt.

2:3.67.4.1.3.1 XDS on FHIR Option

Die Implementierung der "XDS on FHIR"-Option ist im ISiK-Kontext nicht gefordert.

2:3.67.4.2 Find Document References Response Message

2:3.67.4.2.1 Trigger Events

Die Vereinbarungen gelten uneingeschränkt.

2:3.67.4.2.2 Message Semantics

• Suchergebnisse können zahlreich sein. Server MÜSSEN daher FHIR-konformes Paging unterstützen. Server KÖNNEN im SearchSet-Bundle auch Ressourcen vom Typ OperationOutcome mit Informationen über die Suchergebnisse zurückgeben. Diese müssen in Bundle.entry.search.mode mit dem Wert outcome gekennzeichnet sein. Die Issues im OperationOutcome dürfen nur dem Schweregrad information oder warning entsprechen. Issues vom Schweregrad error oder fatal sind unzulässig.
• Das Ergebnis-Bundle der Suche muss konform sein zum Profil "ISiKDokumentenSuchergebnisse"
  diffhybridsnap

  show common

  ISiKDokumentenSuchergebnisse (Bundle)	I		Bundle	There are no (further) constraints on this element Element id Bundle Short description Contains a collection of resources Definition A container for a collection of resources. Data type Bundle Constraints bdl-1: total only when a search or history total.empty() or (type = 'searchset') or (type = 'history') bdl-2: entry.search only when a search entry.search.empty() or (type = 'searchset') bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history')) bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history')) bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) (type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct() bdl-9: A document must have an identifier with a system and a value type = 'document' implies (identifier.system.exists() and identifier.value.exists()) bdl-10: A document must have a date type = 'document' implies (timestamp.hasValue()) bdl-11: A document must have a Composition as the first resource type = 'document' implies entry.first().resource.is(Composition) bdl-12: A message must have a MessageHeader as the first resource type = 'message' implies entry.first().resource.is(MessageHeader) Mappings rim: Entity. Role, or Act v2: N/A rim: N/A cda: ClinicalDocument, if bundle.type = document
  id	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Bundle.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Bundle.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Bundle.identifier Short description Persistent identifier for the bundle Definition A persistent identifier for the bundle that won't change as a bundle is copied from server to server. Comments Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings w5: FiveWs.identifier cda: ClinicalDocument.id
  type	S Σ	1..1	codeBindingFixed Value	Element id Bundle.type Short description Bundle-Typ Definition Indicates the purpose of this bundle - how it is intended to be used. Comments Fix: searchset Data type code Binding Indicates the purpose of a bundle - how it is intended to be used. BundleType (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value searchset Mappings w5: FiveWs.class
  timestamp	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.timestamp Short description When the bundle was assembled Definition The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. Comments For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings w5: FiveWs.init cda: ClinicalDocument.effectiveTime
  total	Σ I	1..1	unsignedInt	Element id Bundle.total Short description Gesamtzahl der Suchtreffer Definition If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Comments Gesamtzahl der Suchtreffer auf dem Server, unabhängig vom Page-Size des aktuellen Bundles Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  link	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Bundle.link Short description Links related to this Bundle Definition A series of links that provide context to this bundle. Comments Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  relation	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.link.relation Short description See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1 Definition A name which details the functional use for this link - see http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.link.url Short description Reference details for the link Definition The reference details for the link. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  entry	Σ I	0..*	BackboneElement	Element id Bundle.entry Short description Entry in the bundle - will have a resource or information Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Data type BackboneElement Sliced: Unordered, Open, by resource(Profile) Constraints bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  (All Slices)				There are no (further) constraints on this element
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  fullUrl	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.fullUrl Short description URI for resource (Absolute URL server address or URI for UUID/OID) Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. Comments fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  resource	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.resource Short description A resource in the bundle Definition The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. Data type Resource
  search	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.search.mode Short description match | include | outcome - why this is in the result set Definition Why this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. Comments There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence. Data type code Binding Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order. See Patient Match for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  request	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.request Short description Additional execution information (transaction/batch/history) Definition Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry.request.method Short description GET | HEAD | POST | PUT | DELETE | PATCH Definition In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.request.ifNoneExist Short description For conditional creates Definition Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  response	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry.response Short description Results of execution (transaction/batch/history) Definition Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.status Short description Status response code (text optional) Definition The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned. This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error. Data type Resource
  DocumentReference	S Σ I	0..*	BackboneElement	Element id Bundle.entry:DocumentReference Short description Suchergebnis Definition An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only). Comments Jedes Suchergebnis wird in einer separaten entry abgebildet. Bundles mit total = 0 haben keine entry Data type BackboneElement Constraints bdl-5: must be a resource unless there's a request or response resource.exists() or request.exists() or response.exists() bdl-8: fullUrl cannot be a version specific reference fullUrl.contains('/_history/').not() ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  link	Σ	0..*	see (link)	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.link Short description Links related to this entry Definition A series of links that provide context to this entry. Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  fullUrl	S Σ	1..1	uri	Element id Bundle.entry:DocumentReference.fullUrl Short description Serverseitige URL der Ressource Definition The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified. Comments Serverseitige URL der Ressource in entry.resource Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  resource	S I	1..1	ISiKDokumentenMetadaten	Element id Bundle.entry:DocumentReference.resource Short description Eingebettete Ressource Definition A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text. Comments Eingebettete Ressource (hier: DocumentReference, die den Suchkriterien entspricht) Data type ISiKDokumentenMetadaten Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-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-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event fhircomposition: when describing a Composition rim: Document[classCode="DOC" and moodCode="EVN"] cda: when describing a CDA
  search	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search Short description Search related information Definition Information about the search process that lead to the creation of this entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search.mode Short description match | include | outcome - why this is in the result set Definition Why this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. Comments There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence. Data type code Binding Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. SearchEntryMode (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  score	Σ	0..1	decimal	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.search.score Short description Search ranking (between 0 and 1) Definition When searching, the server's search ranking score for the entry. Comments Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order. See Patient Match for the EMPI search which relates to this element. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  request	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request Short description Additional execution information (transaction/batch/history) Definition Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  method	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.method Short description GET | HEAD | POST | PUT | DELETE | PATCH Definition In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred. Data type code Binding HTTP verbs (in the HTTP command line). See HTTP rfc for details. HTTPVerb (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  url	Σ	1..1	uri	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.url Short description URL for HTTP equivalent of this entry Definition The URL for this entry, relative to the root (the address to which the request is posted). Comments E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]". Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifNoneMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.ifNoneMatch Short description For managing cache currency Definition If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read". Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifModifiedSince	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.ifModifiedSince Short description For managing cache currency Definition Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read". Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifMatch	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.ifMatch Short description For managing update contention Definition Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention". Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  ifNoneExist	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.request.ifNoneExist Short description For conditional creates Definition Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?"). Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  response	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response Short description Results of execution (transaction/batch/history) Definition Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  id		0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: N/A
  status	Σ	1..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.status Short description Status response code (text optional) Definition The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  location	Σ	0..1	uri	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.location Short description The location (if the operation returns a location) Definition The location header created by processing this operation, populated if the operation returns a location. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  etag	Σ	0..1	string	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.etag Short description The Etag for the resource (if relevant) Definition The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Comments Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  lastModified	Σ	0..1	instant	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.lastModified Short description Server's date time modified Definition The date/time that the resource was modified on the server. Comments This has to match the same time in the meta header (meta.lastUpdated) if a resource is included. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
  outcome	Σ	0..1	Resource	There are no (further) constraints on this element Element id Bundle.entry:DocumentReference.response.outcome Short description OperationOutcome with hints and warnings (for batch/transaction) Definition An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. Comments For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned. This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error. Data type Resource
  signature	Σ	0..1	Signature	There are no (further) constraints on this element Element id Bundle.signature Short description Digital Signature Definition Digital Signature - base64 encoded. XML-DSig or a JWT. Requirements A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. Comments The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())