Release 4 5 Preview #2
This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
FHIR Infrastructure Work Group Maturity Level : N/A Standards Status : Informative

In addition to a list of all differences between DSTU 3 and STU 4 , this specification also provides transforms between R3 and R4 for most resources that were in R3. These transforms are expressed using the FHIR Mapping Language , and both serve as formal documentation of the relationship between the resource structures in R3 and R4, and can also be used to convert between the formats automatically.

The following table summarizes the state of the R3:R4 maps for each resource type.

Note the following:

  • Transforms are tested using the following method:
    1. For each example resource in the R3 release of the FHIR specification that has a transform to R4
    2. apply the transform to R4
    3. validate against the R4 specification
    4. apply the reverse transform back to R3
    5. compare the outcome with the original resource - ideally, it should be identical
  • All transforms should execute - that is, they should be able to take any R3 resource, represent the content in R4, and then generate an R3 representation for the same content. Note, though, that in a few cases, the differences between R3 and R4 designs are so significant that not all examples can be successfully transformed at all.
  • For some resources, the differences in design between R3 and R4 are sufficiently great that the R3 examples cannot reproduce the same output after conversion to R4 and then back to R3. For example, the R4 resource may have a different set of status codes with imperfect maps
  • For some resources, the information available in the R3 examples is not enough to generate valid R4 resources, and so the resources generate R4 validation errors. (e.g. R3 resources missing an element that is required in R4)
  • The transform scripts are only tested to the degree that R3 provided example data
  • For all these reasons, the maps provided in the specification are not authoritative; they are provided to help implementers who need to convert between the R2 and R3 format, but additional revision may be required in an implementation specific context
  • The maps are subject to ongoing maintenance using the FHIR NPM Package " fhir.versions.r3r4 " which is maintained on GitHub . See also FHIR Wiki for other ongoing work to support R3/R4 transformations
Resource # Tests % Execute OK % RoundTrip Ok % R4 Valid R4 Error Count
Account 2 100 0 100
ActivityDefinition 9 100 77 0
AdministrableProductDefinition No r2:r3 maps available
AdverseEvent 1 100 0 0
AllergyIntolerance 3 100 100 100
Appointment 3 100 100 100
AppointmentResponse 2 100 100 100
AuditEvent 8 100 100 100
Basic 3 100 100 100
Binary 2 100 100 100
BiologicallyDerivedProduct No r2:r3 maps available
BodyStructure 3 100 100 100
Bundle 28 89 88 36
CapabilityStatement 9 100 88 0
CapabilityStatement2 No r2:r3 maps available
CarePlan 11 100 100 9
CareTeam 1 100 100 0
CatalogEntry No r2:r3 maps available
ChargeItem 1 100 100 100
ChargeItemDefinition No r2:r3 maps available
Citation No r2:r3 maps available
Claim 16 81 0 76
ClaimResponse 1 100 0 0
ClinicalImpression 1 100 100 100
ClinicalUseIssue No r2:r3 maps available
CodeSystem 4 100 100 25
Communication 3 100 100 33
CommunicationRequest 2 100 100 50
CompartmentDefinition 6 100 83 16
Composition 1 100 100 100
ConceptMap 4 100 100 0
Condition 12 100 100 91
ConditionDefinition No r2:r3 maps available
Consent 12 100 100 0
Contract 7 28 50 -150
Coverage 4 100 75 100
CoverageEligibilityRequest No r2:r3 maps available
CoverageEligibilityResponse No r2:r3 maps available
DetectedIssue 4 100 100 100
Device 9 100 100 88
DeviceDefinition No r2:r3 maps available
DeviceMetric 1 100 100 100
DeviceRequest 2 100 0 50
DeviceUseStatement 1 100 100 100
DiagnosticReport 14 100 100 35
DocumentManifest 2 0 0 0
DocumentReference 1 0 0 0
EffectEvidenceSynthesis No r2:r3 maps available Encounter 10 100 100 70
Endpoint 3 100 100 100
EnrollmentRequest 1 100 0 100
EnrollmentResponse 1 100 100 100
EpisodeOfCare 1 100 100 100
EventDefinition No r2:r3 maps available
Evidence No r2:r3 maps available
EvidenceReport No r2:r3 maps available
EvidenceVariable No r2:r3 maps available
ExampleScenario No r2:r3 maps available
ExplanationOfBenefit 1 100 0 0
FamilyMemberHistory 2 100 100 50
Flag 2 100 100 100
Goal 2 100 100 100
GraphDefinition 1 100 100 0
Group 2 100 100 100
GuidanceResponse 1 100 100 100
HealthcareService 1 100 100 0
ImagingStudy 2 100 50 0
Immunization 3 100 100 0
ImmunizationEvaluation No r2:r3 maps available
ImmunizationRecommendation 1 100 100 100
ImplementationGuide 1 100 100 0
Ingredient No r2:r3 maps available
InsurancePlan No r2:r3 maps available
Invoice No r2:r3 maps available
Library 11 100 100 0
Linkage 1 100 100 100
List 9 100 100 44
Location 6 100 100 83
ManufacturedItemDefinition No r2:r3 maps available
Measure 6 100 100 0
MeasureReport 3 100 100 0
Media 4 100 100 0 Medication 23 100 4 4
MedicationAdministration 14 100 71 0
MedicationDispense 31 100 80 0
MedicationKnowledge No r2:r3 maps available
MedicationRequest 36 100 77 0
MedicationStatement 7 100 57 0 MedicinalProduct No r2:r3 maps available MedicinalProductAuthorization No r2:r3 maps available MedicinalProductContraindication No r2:r3 maps available MedicinalProductIndication No r2:r3 maps available MedicinalProductIngredient No r2:r3 maps available MedicinalProductInteraction No r2:r3 maps available MedicinalProductManufactured No r2:r3 maps available MedicinalProductPackaged No r2:r3 maps available MedicinalProductPharmaceutical MedicationUsage No r2:r3 maps available
MedicinalProductUndesirableEffect MedicinalProductDefinition No r2:r3 maps available
MessageDefinition 3 100 100 33
MessageHeader 1 100 100 0
MolecularSequence 14 100 100 100
NamingSystem 3 100 66 0
NutritionIntake No r2:r3 maps available
NutritionOrder 13 100 100 0
NutritionProduct No r2:r3 maps available
Observation 48 100 100 52
ObservationDefinition No r2:r3 maps available
OperationDefinition 37 100 100 8
OperationOutcome 6 100 100 100
Organization 11 100 100 90
OrganizationAffiliation No r2:r3 maps available
PackagedProductDefinition No r2:r3 maps available
Patient 16 100 100 100
PaymentNotice 1 100 0 0
PaymentReconciliation 1 100 0 0
Permission No r2:r3 maps available
Person 5 100 100 100
PlanDefinition 11 45 100 0
Practitioner 14 100 100 100
PractitionerRole 1 100 100 100
Procedure 15 100 80 93
Provenance 5 100 100 60
Questionnaire 6 100 100 16
QuestionnaireResponse 5 100 80 0
RegulatedAuthorization No r2:r3 maps available
RelatedPerson 4 100 100 100
RequestGroup 2 100 100 0
ResearchDefinition No r2:r3 maps available ResearchElementDefinition No r2:r3 maps available ResearchStudy 1 100 100 100
ResearchSubject 1 100 100 100
RiskAssessment 4 100 100 25
RiskEvidenceSynthesis No r2:r3 maps available Schedule 3 100 100 100
SearchParameter 3 100 100 0
ServiceRequest No r2:r3 maps available
Slot 4 100 100 100
Specimen 4 100 100 50
SpecimenDefinition No r2:r3 maps available
StructureDefinition 206 100 98 0
StructureMap 2 100 100 50
Subscription 2 100 0 100
SubscriptionStatus No r2:r3 maps available
SubscriptionTopic No r2:r3 maps available
Substance 6 100 100 83
SubstanceNucleicAcid SubstanceDefinition No r2:r3 maps available
SubstancePolymer SubstanceNucleicAcid No r2:r3 maps available
SubstanceProtein SubstancePolymer No r2:r3 maps available
SubstanceReferenceInformation SubstanceProtein No r2:r3 maps available
SubstanceSourceMaterial SubstanceReferenceInformation No r2:r3 maps available
SubstanceSpecification SubstanceSourceMaterial No r2:r3 maps available
SupplyDelivery 2 100 100 100
SupplyRequest 1 100 100 0
Task 6 100 50 83
TerminologyCapabilities No r2:r3 maps available
TestReport 1 100 100 100
TestScript 7 100 85 0
ValueSet 8 100 100 0
VerificationResult No r2:r3 maps available
VisionPrescription 2 100 50 0