CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1 United States of America flag

This page is part of the CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: NHSNSubjectBundle - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the nhsn-subject-bundle resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Bundle
Definition

A container for a collection of resources.

Short A Bundle contains a collection of ResourcesContains a collection of resources
Control 0..*
Is Modifier false
Summary false
Invariants 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))
bundle-no-modifier-extensions: MeasureReport Bundle: must not contain any modifierExensions ((descendants().select(modifierExtension)).exists().not())
bundle-all-measurereport-measure-contains-version: MeasureReport Bundle: All MeasureReport entry's measure Canonical must contain version (Bundle.entry.resource.where($this.is(MeasureReport)).all(measure.matches('(\\|)..*$')))
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))
2. Bundle.implicitRules
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.

Short A set of rules under which this content was created
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.

Control 0..1
Type uri
Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Bundle.type
Definition

Indicates the purpose of this bundle - how it is intended to be used.

Short document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Comments

It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

Control 1..1
Binding The codes SHALL be taken from BundleTypehttp://hl7.org/fhir/ValueSet/bundle-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

Indicates the purpose of a bundle - how it is intended to be used.

Type code
Is Modifier false
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Bundle.entry
Definition

An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

Short An entry in the Bundle; will have a Resource or informationEntry in the bundle - will have a resource or information
Control 20..*
Type BackboneElement
Is Modifier false
Summary true
Invariants 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()))
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())
Slicing This element introduces a set of slices on Bundle.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • profile @ resource
  • 8. Bundle.entry.modifierExtension
    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).

    Short Extensions that cannot be ignored even if unrecognized
    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.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    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.

    Alternate Names extensions, user content, modifiers
    Invariants 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())
    10. Bundle.entry:individual-measurereport
    Slice Name individual-measurereport
    Definition

    An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

    Short Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report ListEntry in the bundle - will have a resource or information
    Control 10..*
    Type BackboneElement
    Is Modifier false
    Summary true
    Invariants 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()))
    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())
    12. Bundle.entry:individual-measurereport.modifierExtension
    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).

    Short Extensions that cannot be ignored even if unrecognized
    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.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    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.

    Alternate Names extensions, user content, modifiers
    Invariants 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())
    14. Bundle.entry:individual-measurereport.resource
    Definition

    The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.


    The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

    Short The Bundle entry for an Individual Measure ReportA resource in the bundle
    Control 10..1
    Type MeasureReportResource(DEQM Individual MeasureReport Profile)
    Is Modifier false
    Must Support false
    Summary false
    16. Bundle.entry:patient
    Slice Name patient
    Definition

    An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

    Short The Patients associated with an Individual MeasureReportEntry in the bundle - will have a resource or information
    Control 10..1*
    Type BackboneElement
    Is Modifier false
    Summary true
    Invariants 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()))
    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())
    18. Bundle.entry:patient.modifierExtension
    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).

    Short Extensions that cannot be ignored even if unrecognized
    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.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    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.

    Alternate Names extensions, user content, modifiers
    Invariants 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())
    20. Bundle.entry:patient.resource
    Definition

    The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.


    The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

    Short The Bundle entry for a Patient associated with an Individual Measure ReportA resource in the bundle
    Control 10..1
    Type PatientResource(Cross-Measure Patient Profile)
    Is Modifier false
    Must Support false
    Summary false
    Alternate Names SubjectOfCare Client Resident

    Guidance on how to interpret the contents of this table can be foundhere

    0. Bundle
    Short A Bundle contains a collection of Resources
    Invariants bundle-no-modifier-extensions: MeasureReport Bundle: must not contain any modifierExensions ((descendants().select(modifierExtension)).exists().not())
    bundle-all-measurereport-measure-contains-version: MeasureReport Bundle: All MeasureReport entry's measure Canonical must contain version (Bundle.entry.resource.where($this.is(MeasureReport)).all(measure.matches('(\\|)..*$')))
    2. Bundle.entry
    Short An entry in the Bundle; will have a Resource or information
    Control 2..?
    Slicing This element introduces a set of slices on Bundle.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ resource
    • 4. Bundle.entry:individual-measurereport
      Slice Name individual-measurereport
      Short Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List
      Control 1..*
      6. Bundle.entry:individual-measurereport.resource
      Short The Bundle entry for an Individual Measure Report
      Control 1..?
      Type MeasureReport(DEQM Individual MeasureReport Profile)
      8. Bundle.entry:patient
      Slice Name patient
      Short The Patients associated with an Individual MeasureReport
      Control 1..1
      10. Bundle.entry:patient.resource
      Short The Bundle entry for a Patient associated with an Individual Measure Report
      Control 1..?
      Type Patient(Cross-Measure Patient Profile)

      Guidance on how to interpret the contents of this table can be foundhere

      0. Bundle
      Definition

      A container for a collection of resources.

      Short A Bundle contains a collection of Resources
      Control 0..*
      Is Modifier false
      Summary false
      Invariants 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))
      bundle-no-modifier-extensions: MeasureReport Bundle: must not contain any modifierExensions ((descendants().select(modifierExtension)).exists().not())
      bundle-all-measurereport-measure-contains-version: MeasureReport Bundle: All MeasureReport entry's measure Canonical must contain version (Bundle.entry.resource.where($this.is(MeasureReport)).all(measure.matches('(\\|)..*$')))
      2. Bundle.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      Short Logical id of this artifact
      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.

      Control 0..1
      Type id
      Is Modifier false
      Summary true
      4. Bundle.meta
      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.

      Short Metadata about the resource
      Control 0..1
      Type Meta
      Is Modifier false
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Bundle.implicitRules
      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.

      Short A set of rules under which this content was created
      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.

      Control 0..1
      Type uri
      Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Bundle.language
      Definition

      The base language in which the resource is written.

      Short Language of the resource content
      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).

      Control 0..1
      Binding The codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

      A human language.

      Additional Bindings Purpose
      AllLanguages Max Binding
      Type code
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary false
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Bundle.identifier
      Definition

      A persistent identifier for the bundle that won't change as a bundle is copied from server to server.

      Short Persistent identifier for the bundle
      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.

      Note This is a business identifier, not a resource identifier (see discussion)
      Control 0..1
      Type Identifier
      Is Modifier false
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Bundle.type
      Definition

      Indicates the purpose of this bundle - how it is intended to be used.

      Short document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
      Comments

      It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

      Control 1..1
      Binding The codes SHALL be taken from BundleType
      (required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

      Indicates the purpose of a bundle - how it is intended to be used.

      Type code
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Bundle.timestamp
      Definition

      The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.

      Short When the bundle was assembled
      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.

      Control 0..1
      Type instant
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Bundle.total
      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.

      Short If search, the total number of matches
      Comments

      Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.

      Control 0..1
      This element is affected by the following invariants: bdl-1
      Type unsignedInt
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Bundle.link
      Definition

      A series of links that provide context to this bundle.

      Short Links related 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.

      Control 0..*
      Type BackboneElement
      Is Modifier false
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Bundle.link.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      Short Unique id for inter-element referencing
      Control 0..1
      Type string
      Is Modifier false
      XML Format In the XML format, this property is represented as an attribute.
      Summary false
      22. Bundle.link.extension
      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.

      Short Additional content defined by implementations
      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.

      Control 0..*
      Type Extension
      Is Modifier false
      Summary false
      Alternate Names extensions, user content
      Invariants 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())
      24. Bundle.link.modifierExtension
      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).

      Short Extensions that cannot be ignored even if unrecognized
      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.

      Control 0..*
      Type Extension
      Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summary true
      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.

      Alternate Names extensions, user content, modifiers
      Invariants 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())
      26. Bundle.link.relation
      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.

      Short See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
      Control 1..1
      Type string
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Bundle.link.url
      Definition

      The reference details for the link.

      Short Reference details for the link
      Control 1..1
      Type uri
      Is Modifier false
      Primitive Value This primitive element may be present, or absent, or replaced by an extension
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Bundle.entry
      Definition

      An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

      Short An entry in the Bundle; will have a Resource or information
      Control 2..*
      Type BackboneElement
      Is Modifier false
      Summary true
      Invariants 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()))
      Slicing This element introduces a set of slices on Bundle.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resource
      • 32. Bundle.entry.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        34. Bundle.entry.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        36. Bundle.entry.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        38. Bundle.entry.link
        Definition

        A series of links that provide context to this entry.

        Short Links related to this entry
        Control 0..*
        Type Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Bundle.entry.fullUrl
        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.
        Short URI for resource (Absolute URL server address or URI for UUID/OID)
        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).

        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Bundle.entry.resource
        Definition

        The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

        Short A resource in the bundle
        Control 0..1
        Type Resource
        Is Modifier false
        Summary true
        44. Bundle.entry.search
        Definition

        Information about the search process that lead to the creation of this entry.

        Short Search related information
        Control 0..1
        This element is affected by the following invariants: bdl-2
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Bundle.entry.search.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        48. Bundle.entry.search.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        50. Bundle.entry.search.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        52. Bundle.entry.search.mode
        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.

        Short match | include | outcome - why this is in the result set
        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.

        Control 0..1
        Binding The codes SHALL be taken from SearchEntryMode
        (required to http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1)

        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.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Bundle.entry.search.score
        Definition

        When searching, the server's search ranking score for the entry.

        Short Search ranking (between 0 and 1)
        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.

        Control 0..1
        Type decimal
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Bundle.entry.request
        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.

        Short Additional execution information (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-3
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Bundle.entry.request.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        60. Bundle.entry.request.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        62. Bundle.entry.request.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        64. Bundle.entry.request.method
        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.

        Short GET | HEAD | POST | PUT | DELETE | PATCH
        Control 1..1
        Binding The codes SHALL be taken from HTTPVerb
        (required to http://hl7.org/fhir/ValueSet/http-verb|4.0.1)

        HTTP verbs (in the HTTP command line). See HTTP rfc for details.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Bundle.entry.request.url
        Definition

        The URL for this entry, relative to the root (the address to which the request is posted).

        Short URL for HTTP equivalent of this entry
        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]".

        Control 1..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Bundle.entry.request.ifNoneMatch
        Definition

        If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Bundle.entry.request.ifModifiedSince
        Definition

        Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Bundle.entry.request.ifMatch
        Definition

        Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".

        Short For managing update contention
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Bundle.entry.request.ifNoneExist
        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 "?").

        Short For conditional creates
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Bundle.entry.response
        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.

        Short Results of execution (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-4
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Bundle.entry.response.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        80. Bundle.entry.response.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        82. Bundle.entry.response.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        84. Bundle.entry.response.status
        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.

        Short Status response code (text optional)
        Control 1..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Bundle.entry.response.location
        Definition

        The location header created by processing this operation, populated if the operation returns a location.

        Short The location (if the operation returns a location)
        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Bundle.entry.response.etag
        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).

        Short The Etag for the resource (if relevant)
        Comments

        Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.

        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. Bundle.entry.response.lastModified
        Definition

        The date/time that the resource was modified on the server.

        Short Server's date time modified
        Comments

        This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.

        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. Bundle.entry.response.outcome
        Definition

        An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.

        Short OperationOutcome with hints and warnings (for batch/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.

        Control 0..1
        Type Resource
        Is Modifier false
        Summary true
        94. Bundle.entry:individual-measurereport
        Slice Name individual-measurereport
        Definition

        An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

        Short Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List
        Control 1..*
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants 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()))
        96. Bundle.entry:individual-measurereport.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        98. Bundle.entry:individual-measurereport.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        100. Bundle.entry:individual-measurereport.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        102. Bundle.entry:individual-measurereport.link
        Definition

        A series of links that provide context to this entry.

        Short Links related to this entry
        Control 0..*
        Type Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Bundle.entry:individual-measurereport.fullUrl
        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.
        Short URI for resource (Absolute URL server address or URI for UUID/OID)
        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).

        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. Bundle.entry:individual-measurereport.resource
        Definition

        The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.

        Short The Bundle entry for an Individual Measure Report
        Control 1..1
        Type MeasureReport(DEQM Individual MeasureReport Profile)
        Is Modifier false
        Must Support false
        Summary false
        108. Bundle.entry:individual-measurereport.search
        Definition

        Information about the search process that lead to the creation of this entry.

        Short Search related information
        Control 0..1
        This element is affected by the following invariants: bdl-2
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. Bundle.entry:individual-measurereport.search.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        112. Bundle.entry:individual-measurereport.search.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        114. Bundle.entry:individual-measurereport.search.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        116. Bundle.entry:individual-measurereport.search.mode
        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.

        Short match | include | outcome - why this is in the result set
        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.

        Control 0..1
        Binding The codes SHALL be taken from SearchEntryMode
        (required to http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1)

        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.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        118. Bundle.entry:individual-measurereport.search.score
        Definition

        When searching, the server's search ranking score for the entry.

        Short Search ranking (between 0 and 1)
        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.

        Control 0..1
        Type decimal
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. Bundle.entry:individual-measurereport.request
        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.

        Short Additional execution information (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-3
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        122. Bundle.entry:individual-measurereport.request.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        124. Bundle.entry:individual-measurereport.request.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        126. Bundle.entry:individual-measurereport.request.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        128. Bundle.entry:individual-measurereport.request.method
        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.

        Short GET | HEAD | POST | PUT | DELETE | PATCH
        Control 1..1
        Binding The codes SHALL be taken from HTTPVerb
        (required to http://hl7.org/fhir/ValueSet/http-verb|4.0.1)

        HTTP verbs (in the HTTP command line). See HTTP rfc for details.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        130. Bundle.entry:individual-measurereport.request.url
        Definition

        The URL for this entry, relative to the root (the address to which the request is posted).

        Short URL for HTTP equivalent of this entry
        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]".

        Control 1..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        132. Bundle.entry:individual-measurereport.request.ifNoneMatch
        Definition

        If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        134. Bundle.entry:individual-measurereport.request.ifModifiedSince
        Definition

        Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. Bundle.entry:individual-measurereport.request.ifMatch
        Definition

        Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".

        Short For managing update contention
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. Bundle.entry:individual-measurereport.request.ifNoneExist
        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 "?").

        Short For conditional creates
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        140. Bundle.entry:individual-measurereport.response
        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.

        Short Results of execution (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-4
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        142. Bundle.entry:individual-measurereport.response.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        144. Bundle.entry:individual-measurereport.response.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        146. Bundle.entry:individual-measurereport.response.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        148. Bundle.entry:individual-measurereport.response.status
        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.

        Short Status response code (text optional)
        Control 1..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        150. Bundle.entry:individual-measurereport.response.location
        Definition

        The location header created by processing this operation, populated if the operation returns a location.

        Short The location (if the operation returns a location)
        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        152. Bundle.entry:individual-measurereport.response.etag
        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).

        Short The Etag for the resource (if relevant)
        Comments

        Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.

        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        154. Bundle.entry:individual-measurereport.response.lastModified
        Definition

        The date/time that the resource was modified on the server.

        Short Server's date time modified
        Comments

        This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.

        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        156. Bundle.entry:individual-measurereport.response.outcome
        Definition

        An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.

        Short OperationOutcome with hints and warnings (for batch/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.

        Control 0..1
        Type Resource
        Is Modifier false
        Summary true
        158. Bundle.entry:patient
        Slice Name patient
        Definition

        An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

        Short The Patients associated with an Individual MeasureReport
        Control 1..1
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants 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()))
        160. Bundle.entry:patient.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        162. Bundle.entry:patient.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        164. Bundle.entry:patient.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        166. Bundle.entry:patient.link
        Definition

        A series of links that provide context to this entry.

        Short Links related to this entry
        Control 0..*
        Type Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        168. Bundle.entry:patient.fullUrl
        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.
        Short URI for resource (Absolute URL server address or URI for UUID/OID)
        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).

        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        170. Bundle.entry:patient.resource
        Definition

        The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.

        Short The Bundle entry for a Patient associated with an Individual Measure Report
        Control 1..1
        Type Patient(Cross-Measure Patient Profile)
        Is Modifier false
        Must Support false
        Summary false
        Alternate Names SubjectOfCare Client Resident
        172. Bundle.entry:patient.search
        Definition

        Information about the search process that lead to the creation of this entry.

        Short Search related information
        Control 0..1
        This element is affected by the following invariants: bdl-2
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        174. Bundle.entry:patient.search.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        176. Bundle.entry:patient.search.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        178. Bundle.entry:patient.search.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        180. Bundle.entry:patient.search.mode
        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.

        Short match | include | outcome - why this is in the result set
        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.

        Control 0..1
        Binding The codes SHALL be taken from SearchEntryMode
        (required to http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1)

        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.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        182. Bundle.entry:patient.search.score
        Definition

        When searching, the server's search ranking score for the entry.

        Short Search ranking (between 0 and 1)
        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.

        Control 0..1
        Type decimal
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        184. Bundle.entry:patient.request
        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.

        Short Additional execution information (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-3
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        186. Bundle.entry:patient.request.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        188. Bundle.entry:patient.request.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        190. Bundle.entry:patient.request.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        192. Bundle.entry:patient.request.method
        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.

        Short GET | HEAD | POST | PUT | DELETE | PATCH
        Control 1..1
        Binding The codes SHALL be taken from HTTPVerb
        (required to http://hl7.org/fhir/ValueSet/http-verb|4.0.1)

        HTTP verbs (in the HTTP command line). See HTTP rfc for details.

        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        194. Bundle.entry:patient.request.url
        Definition

        The URL for this entry, relative to the root (the address to which the request is posted).

        Short URL for HTTP equivalent of this entry
        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]".

        Control 1..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        196. Bundle.entry:patient.request.ifNoneMatch
        Definition

        If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        198. Bundle.entry:patient.request.ifModifiedSince
        Definition

        Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".

        Short For managing cache currency
        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        200. Bundle.entry:patient.request.ifMatch
        Definition

        Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".

        Short For managing update contention
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        202. Bundle.entry:patient.request.ifNoneExist
        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 "?").

        Short For conditional creates
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        204. Bundle.entry:patient.response
        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.

        Short Results of execution (transaction/batch/history)
        Control 0..1
        This element is affected by the following invariants: bdl-4
        Type BackboneElement
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        206. Bundle.entry:patient.response.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        208. Bundle.entry:patient.response.extension
        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.

        Short Additional content defined by implementations
        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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants 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())
        210. Bundle.entry:patient.response.modifierExtension
        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).

        Short Extensions that cannot be ignored even if unrecognized
        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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summary true
        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.

        Alternate Names extensions, user content, modifiers
        Invariants 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())
        212. Bundle.entry:patient.response.status
        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.

        Short Status response code (text optional)
        Control 1..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        214. Bundle.entry:patient.response.location
        Definition

        The location header created by processing this operation, populated if the operation returns a location.

        Short The location (if the operation returns a location)
        Control 0..1
        Type uri
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        216. Bundle.entry:patient.response.etag
        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).

        Short The Etag for the resource (if relevant)
        Comments

        Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.

        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        218. Bundle.entry:patient.response.lastModified
        Definition

        The date/time that the resource was modified on the server.

        Short Server's date time modified
        Comments

        This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.

        Control 0..1
        Type instant
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        220. Bundle.entry:patient.response.outcome
        Definition

        An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.

        Short OperationOutcome with hints and warnings (for batch/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.

        Control 0..1
        Type Resource
        Is Modifier false
        Summary true
        222. Bundle.signature
        Definition

        Digital Signature - base64 encoded. XML-DSig or a JWT.

        Short Digital Signature
        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.

        Control 0..1
        Type Signature
        Is Modifier false
        Summary true
        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.

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