R4 Ballot #1 (Mixed Normative/Trial use) Current Build
This is the FHIR R4 Mixed Normative/Trial Use Ballot #1, and the version for the Cologne Connectathon in May 2018. The current version is R3 . See the ballot introduction for details about the ballot. For a full list of available versions, see the Directory of published versions and Timelines for an explanation of STU and other statuses.
FHIR Infrastructure Work Group Maturity Level : 4 Normative Ballot Standards Status : Normative
Normative Candidate Note: Most of the content on this page is candidate normative content for R4 in the Infrastructure Package . Once normative, it will lose it's Maturity Level, and breaking changes will no longer be made. The few parts of this page that are not normative are clearly marked null

This page provides the detailed descriptions for the data types

Table of Contents

Primitive Types
Element instant time date dateTime decimal boolean integer string uri base64Binary code id oid unsignedInt positiveInt markdown url canonical uuid
Complex Types
Element Identifier HumanName Address ContactPoint Timing Quantity SimpleQuantity Attachment Range Period Ratio CodeableConcept Coding SampledData Age Distance Duration Count Money MoneyQuantity Annotation Signature BackboneElement

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

todo

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Attachment
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Attachment
Definition

For referring to data content defined in other formats.

Control Cardinality 1..1 0..*
Type Element
Requirements

Many models need to include data defined in other specifications that is complex and opaque to the healthcare model. This includes documents, media recordings, structured data, etc.

Comments

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". "Signed Procedure Consent".

Invariants
Defined on this element
att-1 : Rule If the Attachment has data, it SHALL have a contentType ( expression : data.empty() or contentType.exists(), xpath: not(exists(f:data)) or exists(f:contentType)) contentType.exists()
Attachment.contentType
Element Id Attachment.contentType
Definition

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

Control Cardinality 0..1
Terminology Binding MimeType : ( Required )
Type code
Requirements

Processors of the data need to be able to know how to interpret the data.

Summary true
Attachment.language
Element Id Attachment.language
Definition

The human language of the content. The value can be any valid value according to BCP 47.

Control Cardinality 0..1
Terminology Binding Common Languages ( Extensible Preferred but limited to ??) All Languages )
Type code
Requirements

Users need to be able to choose between the languages in a set of attachments.

Summary true
Attachment.data
Element Id Attachment.data
Definition

The actual data of the attachment - a sequence of bytes. In XML, represented using base64. bytes, base64 encoded.

Control Cardinality 0..1
Type base64Binary
Requirements

The data needs to able to be transmitted inline.

Comments

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

Attachment.url
Element Id Attachment.url
Definition

An alternative A location where the data can be accessed.

Control Cardinality 0..1
Type url
Requirements

The data needs to be transmitted by reference.

Summary true
Comments

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

Attachment.size
Element Id Attachment.size
Definition

The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

Control Cardinality 0..1
Type unsignedInt
Requirements

Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

Summary true
Comments

The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

Attachment.hash
Element Id Attachment.hash
Definition

The calculated hash of the data using SHA-1. Represented using base64.

Control Cardinality 0..1
Type base64Binary
Requirements

Included so that applications can verify that the contents of a location have not changed duse due to technical failures (e.g., storage rot, transport glitch, incorrect version).

Summary true
Comments

The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

Attachment.title
Element Id Attachment.title
Definition

A label or set of text to display in place of the data.

Control Cardinality 0..1
Type string
Requirements

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

Summary true
Attachment.creation
Element Id Attachment.creation
Definition

The date that the attachment was first created.

Control Cardinality 0..1
Type dateTime
Requirements

This is often tracked as an integrity issue for use of the attachment.

Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Identifier
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Identifier
Definition

A technical An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to be able to identify things with confidence and be sure that the identification is not subject to misinterpretation.

Summary true
Identifier.use
Element Id Identifier.use
Definition

The purpose of this identifier.

Control Cardinality 0..1
Terminology Binding IdentifierUse ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.)
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Summary true
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifier.type
Element Id Identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control Cardinality 0..1
Terminology Binding Identifier Type Codes IdentifierType ( Extensible )
Type CodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Summary true
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Identifier.system
Element Id Identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control Cardinality 0..1
Type uri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Summary true
Comments

Identifier.system is always case sensitive.

Identifier.value
Element Id Identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control Cardinality 0..1
Type string
Summary true
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension . Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Identifier.period
Element Id Identifier.period
Definition

Time period during which identifier is/was valid for use.

Control Cardinality 0..1
Type Period
Summary true
Identifier.assigner
Element Id Identifier.assigner
Definition

Organization that issued/manages the identifier.

Control Cardinality 0..1
Type Reference ( Organization )
Summary true
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Coding
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Coding
Definition

A reference to a code defined by a terminology system.

Control Cardinality 1..1 0..*
Type Element
Requirements

References to codes are very common in healthcare models.

Summary true
Comments

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

Coding.system
Element Id Coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control Cardinality 0..1
Type uri
Requirements

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

Summary true
Comments

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

Coding.version
Element Id Coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Note This is a business versionId, not a resource version id (see discussion )
Control Cardinality 0..1
Type string
Summary true
Comments

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

Coding.code
Element Id Coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control Cardinality 0..1
Type code
Requirements

Need to refer to a particular code in the system.

Summary true
Coding.display
Element Id Coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control Cardinality 0..1
Type string
Requirements

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

Summary true
Coding.userSelected
Element Id Coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. e.g. off a pick list of available items (codes or displays).

Control Cardinality 0..1
Type boolean
Requirements

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

Summary true
Comments

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

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

CodeableConcept
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id CodeableConcept
Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Control Cardinality 1..1 0..*
Type Element
Requirements

This is a common pattern in healthcare - a concept that may be defined by one or more codes from formal definitions including LOINC and SNOMED CT, and/or defined by the provision of text that captures a human sense of the concept.

Summary true
Comments

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

CodeableConcept.coding
Element Id CodeableConcept.coding
Definition

A reference to a code defined by a terminology system.

Control Cardinality 0..*
Type Coding
Requirements

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

Summary true
Comments

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

CodeableConcept.text
Element Id CodeableConcept.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control Cardinality 0..1
Type string
Requirements

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

Summary true
Comments

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

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Quantity
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Quantity
Definition

A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.

Summary true
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
Defined on this element
qty-3 : Rule If a code for the unit is present, the system SHALL also be present ( expression : code.empty() or system.exists(), xpath: not(exists(f:code)) or exists(f:system)) system.exists()
Quantity.value
Element Id Quantity.value
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Control Cardinality 0..1
Type decimal
Requirements

Precision is handled implicitly in almost all cases of measurement.

Summary true
Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Quantity.comparator
Element Id Quantity.comparator
Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Control Cardinality 0..1
Terminology Binding QuantityComparator ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value)
Meaning if Missing If there is no comparator, then there is no modification of the value
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Summary true
Quantity.unit
Element Id Quantity.unit
Definition

A human-readable form of the unit.

Control Cardinality 0..1
Type string
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Summary true
Quantity.system
Element Id Quantity.system
Definition

The identification of the system that provides the coded form of the unit.

Control Cardinality 0..1
Type uri
Requirements

Need to know the system that defines the coded form of the unit.

Summary true
Invariants
Affect this element
qty-3 : Rule If a code for the unit is present, the system SHALL also be present ( expression : code.empty() or system.exists(), xpath: not(exists(f:code)) or exists(f:system)) system.exists()
Quantity.code
Element Id Quantity.code
Definition

A computer processable form of the unit in some unit representation system.

Control Cardinality 0..1
Type code
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Summary true
Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Money
Standards Status This element has a standards status of "Normative"
Element Id Money
Definition

An amount of economic utility in some recognized currency.

Cardinality 0..*
Type Element
Summary true
Money.value
Element Id Money.value
Definition

Numerical value (with implicit precision).

Cardinality 0..1
Type decimal
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Summary true
Comments

Monetary values have their own rules for handling precision (refer to standard accounting text books).

Money.currency
Element Id Money.currency
Definition

ISO 4217 Currency Code.

Cardinality 0..1
Terminology Binding CurrencyCode ( Required )
Type code
Requirements

A code indicating the currency, taken from ISO 4217.

Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Range
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Range
Definition

A set of ordered Quantities defined by a low and high limit.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to be able to specify ranges of values.

Summary true
Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Invariants
Defined on this element
rng-2 : Rule If present, low SHALL have a lower value than high ( expression : low.empty() or high.empty() or (low <= high), xpath: not(exists(f:low/f:value/@value)) or not(exists(f:high/f:value/@value)) or (number(f:low/f:value/@value) <= number(f:high/f:value/@value))) high)
Range.low
Element Id Range.low
Definition

The low limit. The boundary is inclusive.

Control Cardinality 0..1
Type SimpleQuantity
Summary true
Comments

If the low element is missing, the low boundary is not known.

Range.high
Element Id Range.high
Definition

The high limit. The boundary is inclusive.

Control Cardinality 0..1
Type SimpleQuantity
Summary true
Comments

If the high element is missing, the high boundary is not known.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Ratio
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Ratio
Definition

A relationship of two Quantity values - expressed as a numerator and a denominator.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to able to capture ratios for some measurements (titers) and some rates (costs).

Summary true
Comments

The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

Invariants
Defined on this element
rat-1 : Rule Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ( expression : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()), xpath: (count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))) extension.exists())
Ratio.numerator
Element Id Ratio.numerator
Definition

The value of the numerator.

Control Cardinality 0..1
Type Quantity
Summary true
Ratio.denominator
Element Id Ratio.denominator
Definition

The value of the denominator.

Control Cardinality 0..1
Type Quantity
Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Period
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Period
Definition

A time period defined by a start and end date and optionally time.

Control Cardinality 1..1 0..*
Type Element
Summary true
Comments

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

Period is required, specify the type as Interval|Duration. not used for a duration (a measure of elapsed time). See Duration .

Invariants
Defined on this element
per-1 : Rule If present, start SHALL have a lower value than end ( expression : start.hasValue().not() or end.hasValue().not() or (start <= end), xpath: not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))) end)
Period.start
Element Id Period.start
Definition

The start of the period. The boundary is inclusive.

Control Cardinality 0..1
Type dateTime
Summary true
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
Affect this element
per-1 : Rule If present, start SHALL have a lower value than end ( expression : start.hasValue().not() or end.hasValue().not() or (start <= end), xpath: not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))) end)
Period.end
Element Id Period.end
Definition

The end of the period. If the end of the period is missing, it means that no end was known or planned at the period is ongoing. time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control Cardinality 0..1
Type dateTime
Meaning if Missing If the end of the period is missing, it means that the period is ongoing
Summary true
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a an end value of 2012-02-03.

Invariants
Affect this element
per-1 : Rule If present, start SHALL have a lower value than end ( expression : start.hasValue().not() or end.hasValue().not() or (start <= end), xpath: not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))) end)

Normative Candidate Note: This DataType is not normative - it is still undergoing Trial Use while more experience is gathered.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

SampledData
Standards Status This element has a standards status of "Trial Use" which is different to the status of the whole resource
Element Id SampledData
Definition

A series of measurements taken by a device, with upper and lower limits. There may be more than one dimension in the data.

Control Cardinality 1..1 0..*
Type Element
Requirements

There is a need for a concise way to handle the data produced by devices that sample a physical state at a high frequency.

Comments

The data is not interpretable without at least origin, period, and dimensions, but these are optional to allow a separation between the template of measurement and the actual measurement, such as between DeviceCapabilities and DeviceLog. When providing a summary view (for example with Observation.value[x]) SampledData should be represented with a brief display text such as "Sampled Data".

SampledData.origin
Element Id SampledData.origin
Definition

The base quantity that a measured value of zero represents. In addition, this provides the units of the entire measurement series.

Control Cardinality 1..1
Type SimpleQuantity
Summary true
SampledData.period
Element Id SampledData.period
Definition

The length of time between sampling times, measured in milliseconds.

Control Cardinality 1..1
Type decimal
Summary true
Comments

This is usually a whole number.

SampledData.factor
Element Id SampledData.factor
Definition

A correction factor that is applied to the sampled data points before they are added to the origin.

Control Cardinality 0..1
Type decimal
Meaning if Missing If no factor is assigned, the data is not adjusted before adding to the origin
Summary true
SampledData.lowerLimit
Element Id SampledData.lowerLimit
Definition

The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit).

Control Cardinality 0..1
Type decimal
Summary true
SampledData.upperLimit
Element Id SampledData.upperLimit
Definition

The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit).

Control Cardinality 0..1
Type decimal
Summary true
SampledData.dimensions
Element Id SampledData.dimensions
Definition

The number of sample points at each time point. If this value is greater than one, then the dimensions will be interlaced - all the sample points for a point in time will be recorded at once.

Control Cardinality 1..1
Type positiveInt
Summary true
Comments

If there is more than one dimension, the code for the type of data will define the meaning of the dimensions (typically ECG data).

SampledData.data
Element Id SampledData.data
Definition

A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) can also be used in place of a decimal value.

Control Cardinality 0..1
Type string
Comments

Data may be missing if it is omitted for summarization purposes. In general, data is required for any actual use of a SampledData.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

HumanName
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id HumanName
Definition

A human's name with the ability to identify parts and usage.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to be able to record names, along with notes about their use.

Summary true
Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

HumanName.use
Element Id HumanName.use
Definition

Identifies the purpose for this name.

Control Cardinality 0..1
Terminology Binding NameUse ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one)
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Summary true
Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

HumanName.text
Element Id HumanName.text
Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Control Cardinality 0..1
Type string
Requirements

A renderable, unencoded form.

Summary true
Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

HumanName.family
Element Id HumanName.family
Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Control Cardinality 0..1
Type string
Alternate Names surname
Summary true
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

HumanName.given
Element Id HumanName.given
Definition

Given name.

Control Cardinality 0..*
Type string
Element Order Meaning Given Names appear in the correct order for presenting the name
Alternate Names first name; middle name
Summary true
Comments

If only initials are recorded, they may be used in place of the full name. Not name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

HumanName.prefix
Element Id HumanName.prefix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Control Cardinality 0..*
Type string
Element Order Meaning Prefixes appear in the correct order for presenting the name
Summary true
HumanName.suffix
Element Id HumanName.suffix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Control Cardinality 0..*
Type string
Element Order Meaning Suffixes appear in the correct order for presenting the name
Summary true
HumanName.period
Element Id HumanName.period
Definition

Indicates the period of time when this name was valid for the named person.

Control Cardinality 0..1
Type Period
Requirements

Allows names to be placed in historical context.

Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Address
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Address
Definition

An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to be able to record postal addresses, along with notes about their use.

Summary true
Comments

Note: address is for intended to describe postal addresses, addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations. locations (also see the Location resource).

Address.use
Element Id Address.use
Definition

The purpose of this address.

Control Cardinality 0..1
Terminology Binding AddressUse ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one)
Requirements

Allows an appropriate address to be chosen from a list of many.

Summary true
Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Address.type
Element Id Address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Control Cardinality 0..1
Terminology Binding AddressType ( Required )
Type code
Summary true
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Address.text
Element Id Address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Control Cardinality 0..1
Type string
Requirements

A renderable, unencoded form.

Summary true
Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Address.line
Element Id Address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control Cardinality 0..*
Type string
Element Order Meaning The order in which lines should appear in an address label
Summary true
Address.city
Element Id Address.city
Definition

The name of the city, town, suburb, village or other community or delivery center.

Control Cardinality 0..1
Type string
Alternate Names Municpality
Summary true
Address.district
Element Id Address.district
Definition

The name of the administrative area (county).

Control Cardinality 0..1
Type string
Alternate Names County
Summary true
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Address.state
Element Id Address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. (e.g. US 2 letter state codes).

Control Cardinality 0..1
Type string
Alternate Names Province; Territory
Summary true
Address.postalCode
Element Id Address.postalCode
Definition

A postal code designating a region defined by the postal service.

Control Cardinality 0..1
Type string
Alternate Names Zip
Summary true
Address.country
Element Id Address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control Cardinality 0..1
Type string
Summary true
Comments

ISO 3166 3 letter codes can be used in place of a full human readable country name.

Address.period
Element Id Address.period
Definition

Time period when address was/is in use.

Control Cardinality 0..1
Type Period
Requirements

Allows addresses to be placed in historical context.

Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

ContactPoint
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id ContactPoint
Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Control Cardinality 1..1 0..*
Type Element
Requirements

Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.

Summary true
Invariants
Defined on this element
cpt-2 : Rule A system is required if a value is provided. ( expression : value.empty() or system.exists(), xpath: not(exists(f:value)) or exists(f:system)) system.exists()
ContactPoint.system
Element Id ContactPoint.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control Cardinality 0..1
Terminology Binding ContactPointSystem ( Required )
Type code
Summary true
Invariants
Affect this element
cpt-2 : Rule A system is required if a value is provided. ( expression : value.empty() or system.exists(), xpath: not(exists(f:value)) or exists(f:system)) system.exists()
ContactPoint.value
Element Id ContactPoint.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control Cardinality 0..1
Type string
Requirements

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

Summary true
Comments

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

ContactPoint.use
Element Id ContactPoint.use
Definition

Identifies the purpose for the contact point.

Control Cardinality 0..1
Terminology Binding ContactPointUse ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one)
Requirements

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

Summary true
Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

ContactPoint.rank
Element Id ContactPoint.rank
Definition

Specifies a preferred order in which to use a set of contacts. Contacts are ranked ContactPoints with lower rank values coming before are more preferred than those with higher rank values.

Control Cardinality 0..1
Type positiveInt
Summary true
Comments

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

ContactPoint.period
Element Id ContactPoint.period
Definition

Time period when the contact point was/is in use.

Control Cardinality 0..1
Type Period
Summary true

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Timing
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Timing
Definition

Specifies an event that may occur multiple times. Timing schedules are used to record when things are planned, expected or requested to occur. The most common usage is in dosage instructions for medications. They are also used when planning care of various kinds, and may be used for reporting the schedule to which past regular activities were carried out.

Control Cardinality 1..1 0..*
Type BackboneElement
Requirements

Need to able to track proposed timing schedules. There are several different ways to do this: one or more specified times, a simple rules like three times a day, or before/after meals.

Summary true
Comments

Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.

Timing.event
Element Id Timing.event
Definition

Identifies specific times when the event occurs.

Control Cardinality 0..*
Type dateTime
Requirements

In an MAR, a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

Summary true
Timing.repeat
Element Id Timing.repeat
Definition

A set of rules that describe when the event is scheduled.

Control Cardinality 0..1
Requirements

Many timing schedules are determined by regular repetitions.

Summary true
Invariants : timeOfDay.empty() or when.empty(), xpath: not(exists(f:timeOfDay)) or not(exists(f:when)))
Defined on this element
tim-1 : Rule if there's a duration, there needs to be duration units ( expression : duration.empty() or durationUnit.exists(), xpath: not(exists(f:duration)) or exists(f:durationUnit)) durationUnit.exists() tim-10 : If there's a timeOfDay, there cannot be be a when, or vice versa ( expression
tim-2 : Rule if there's a period, there needs to be period units ( expression : period.empty() or periodUnit.exists(), xpath: not(exists(f:period)) or exists(f:periodUnit)) periodUnit.exists()
tim-4 : Rule duration SHALL be a non-negative value ( expression : duration.exists() implies duration >= 0, xpath: f:duration/@value >= 0 or not(f:duration/@value))
tim-5 : Rule period SHALL be a non-negative value ( expression : period.exists() implies period >= 0, xpath: f:period/@value >= 0 or not(f:period/@value))
tim-6 : Rule If there's a periodMax, there must be a period ( expression : periodMax.empty() or period.exists(), xpath: not(exists(f:periodMax)) or exists(f:period)) period.exists()
tim-7 : Rule If there's a durationMax, there must be a duration ( expression : durationMax.empty() or duration.exists(), xpath: not(exists(f:durationMax)) or exists(f:duration)) duration.exists()
tim-8 : Rule If there's a countMax, there must be a count ( expression : countMax.empty() or count.exists(), xpath: not(exists(f:countMax)) or exists(f:count)) count.exists()
tim-9 : Rule If there's an offset, there must be a when (and not C, CM, CD, CV) ( expression : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())), xpath: not(exists(f:offset)) 'CV')).not()))
tim-10 Rule If there's a timeOfDay, there cannot be a when, or exists(f:when)) vice versa timeOfDay.empty() or when.empty()
Timing.repeat.bounds[x]
Element Id Timing.repeat.bounds[x]
Definition

Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

Control Cardinality 0..1
Type Duration | Range | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Summary true
Timing.repeat.count
Element Id Timing.repeat.count
Definition

A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

Control Cardinality 0..1
Type integer positiveInt
Requirements

Repetitions may be limited by end time or total occurrences.

Summary true
Comments

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

Timing.repeat.countMax
Element Id Timing.repeat.countMax
Definition

A maximum value for If present, indicates that the count of is a range - so to perform the desired repetitions (e.g. do something 6-8 times). action between [count] and [countMax] times.

Control Cardinality 0..1
Type integer positiveInt
Summary true
Timing.repeat.duration
Element Id Timing.repeat.duration
Definition

How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

Control Cardinality 0..1
Type decimal
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Summary true
Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

Timing.repeat.durationMax
Element Id Timing.repeat.durationMax
Definition

The upper limit of how long this thing happens for when it happens. If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

Control Cardinality 0..1
Type decimal
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Summary true
Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

Timing.repeat.durationUnit
Element Id Timing.repeat.durationUnit
Definition

The units of time for the duration, in UCUM units.

Control Cardinality 0..1
Terminology Binding UnitsOfTime ( Required )
Type code
Summary true
Timing.repeat.frequency
Element Id Timing.repeat.frequency
Definition

The number of times to repeat the action within the specified period / period period. If frequencyMax is present, this element indicates the lower bound of the allowed range (i.e. both period and periodMax provided). of the frequency.

Control Cardinality 0..1
Type integer positiveInt
Meaning if Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Summary true
Timing.repeat.frequencyMax
Element Id Timing.repeat.frequencyMax
Definition

If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

Control Cardinality 0..1
Type integer positiveInt
Summary true
Timing.repeat.period
Element Id Timing.repeat.period
Definition

Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

Control Cardinality 0..1
Type decimal
Summary true
Timing.repeat.periodMax
Element Id Timing.repeat.periodMax
Definition

If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

Control Cardinality 0..1
Type decimal
Summary true
Timing.repeat.periodUnit
Element Id Timing.repeat.periodUnit
Definition

The units of time for the period in UCUM units.

Control Cardinality 0..1
Terminology Binding UnitsOfTime ( Required )
Type code
Summary true
Timing.repeat.dayOfWeek
Element Id Timing.repeat.dayOfWeek
Definition

If one or more days of week is provided, then the action happens only on the specified day(s).

Control Cardinality 0..*
Terminology Binding DaysOfWeek ( Required )
Type code
Summary true
Comments

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

Timing.repeat.timeOfDay
Element Id Timing.repeat.timeOfDay
Definition

Specified time of day for action to take place.

Control Cardinality 0..*
Type time
Summary true
Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

Timing.repeat.when
Element Id Timing.repeat.when
Definition

An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

Control Cardinality 0..*
Terminology Binding EventTiming ( Required )
Type code
Requirements

Timings are frequently determined by occurrences such as waking, eating and sleep.

Summary true
Comments

When more than one event is listed, the event is tied to the union of the specified events.

Timing.repeat.offset
Element Id Timing.repeat.offset
Definition

The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

Control Cardinality 0..1
Type unsignedInt
Summary true
Timing.code
Element Id Timing.code
Definition

A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

Control Cardinality 0..1
Terminology Binding TimingAbbreviation ( Preferred )
Type CodeableConcept
Summary true
Comments

BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or the a structured representation should be used (in this case, specifying the two event times).

Normative Candidate Note: This DataType is not normative - it is still undergoing Trial Use while more experience is gathered.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Signature
Standards Status This element has a standards status of "Trial Use" which is different to the status of the whole resource
Element Id Signature
Definition

A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

Control Cardinality 1..1 0..*
Type Element
Requirements

There are a number of places where content must be signed in healthcare.

Comments

The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.

Signature.type
Element Id Signature.type
Definition

An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

Control Cardinality 1..*
Terminology Binding Signature Type Codes ( Preferred )
Type Coding
Summary true
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a &quot;Commitment Type Indication&quot;.

Signature.when
Element Id Signature.when
Definition

When the digital signature was signed.

Control Cardinality 1..1
Type instant
Summary true
Comments

This should agree with the information in the signature.

Signature.who[x] Signature.who
Element Id Signature.who[x] Signature.who
Definition

A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

Control Cardinality 1..1
Type uri | Reference ( Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization )
[x] Note See Choice of Data Types for further information about how to use [x] Summary true
Comments

This should agree with the information in the signature.

Signature.onBehalfOf[x] Signature.onBehalfOf
Element Id Signature.onBehalfOf[x] Signature.onBehalfOf
Definition

A reference to an application-usable description of the identity that is represented by the signature.

Control Cardinality 0..1
Type uri | Reference ( Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization )
[x] Note See Choice of Data Types for further information about how to use [x] Requirements

used when the signature is on behalf of a non-signer.

Summary true
Comments

The party that can't sign. For example a child.

Signature.targetFormat
Element Id Signature.targetFormat
Definition

A mime type that indicates the technical format of the target resources signed by the signature.

Control Cardinality 0..1
Terminology Binding MimeType : ( Required )
Type code
Comments

"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

Signature.sigFormat
Element Id Signature.sigFormat
Definition

A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.

Control Cardinality 0..1
Terminology Binding MimeType : ( Required )
Type code
Signature.blob Signature.data
Element Id Signature.blob Signature.data
Definition

The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

Control Cardinality 0..1
Type base64Binary
Comments

Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

See also Base Definition , Examples , Profiles & Extensions , Mappings and R2 Conversions .

Annotation
Standards Status This element has a standards status of "Normative" which is different to the status of the whole resource
Element Id Annotation
Definition

A text note which also contains information about who made the statement and when.

Control Cardinality 1..1 0..*
Type Element
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Annotation.author[x]
Element Id Annotation.author[x]
Definition

The individual responsible for making the annotation.

Control Cardinality 0..1
Type Reference ( Practitioner | Patient | RelatedPerson | Organization )| string
[x] Note See Choice of Data Types for further information about how to use [x]
Summary true
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Annotation.time
Element Id Annotation.time
Definition

Indicates when this particular annotation was made.

Control Cardinality 0..1
Type dateTime
Summary true
Annotation.text
Element Id Annotation.text
Definition

The text of the annotation. annotation in markdown format.

Control Cardinality 1..1
Type string markdown
Summary true