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8.3 Resource Group - Content

Responsible Owner: FHIR Infrastructure icon Work Group NormativeSecurity Category: Business Compartments: Device, Patient, Practitioner

Represents a defined collection of entities that may be discussed or acted upon collectively but which are not typically expected to act collectively. These collections are also not typically formally or legally recognized.

NOTE: Group may be used to define families or households, which in some circumstances may act collectively or have a degree of legal or formal recognition. This should be considered an exception. When Group is used for types of entities other than Patient or RelatedPerson, the expectation remains that the Group will not act collectively or have formal recognition - use Organization if these behaviors are needed.

For example, it is possible for a 'family' Group to be a performer of an Observation or owner of a Task. However, this is not permitted for a Group made up of Practitioners, PractitionerRoles or Organizations. Organization or CareTeam would need to be used instead. A Group of Practitioners could, however, be a subject of an Observation.

8.3.1 Scope and Usage

8.3.1.1 Use Cases

The Group resource is used in one of two ways:

  1. To define a group of specific people, animals, devices, etc. that is being tracked, examined, acting collectively or otherwise referenced as part of healthcare-related activities
  2. To define a set of possible people, animals, devices, etc. that are of interest for some intended future healthcare-related activities

Examples of the former could include a family, a household, or group therapy or treatment sessions, exposed entities tracked as part of public health, etc. The latter might be used to define expected subjects for a clinical study.

Both use cases are handled by a single resource because the data elements captured tend to be similar.

NOTE: While Specimen does not quite fit with this definition, it is being retained as part of Group to avoid making a breaking change to the Observation resource.

8.3.1.2 Defining Group Inclusion and Exclusion Criteria

The Group definition, specifying the criteria for membership in the Group, may be expressed with one or more Group.characteristic elements. Here we describe how the Group StructureDefinition is used to express inclusion and exclusion criteria for group membership.

8.3.1.2.1 Group.membership

Group.membership requires one of three codes:

  • 'enumerated': Use this code if the Group Resource lists the group members and/or specifies the number of entities in the group. Use of the 'enumerated' code will require use of the Group.type element.
  • 'definitional': Use this code if the Group Resource provides structured data (i.e. the Group.characteristic values) that is necessary and sufficient to define the qualifications for group membership (the inclusion and exclusion criteria for defining what makes something a member of the group). Use of the 'definitional' code will require use of the Group.type element. If a group is both enumerated and definitional, then use the enumerated code.
  • 'conceptual': Use this code if the Group Resource is an abstract representation of a group that is neither enumerated (listing or counting actual members) nor definitional (providing complete definition for membership qualifications). A different use of the 'conceptual' code is when the Group is otherwise 'definitional' but the Group.type cannot be used because the actual type value is not included in FHIR types.

8.3.1.2.2 Group.combinationMethod

Group.combinationMethod is used when there are two or more Group.characteristic instances to define how the characteristics are combined.

  • Use a code 'all-of' to indicate that each of the characteristics must be met. This is functionally equivalent to combining all characteristics with an AND operator.
  • Use a code 'any-of' to indicate that at least one of the characteristics must be met. This is functionally equivalent to combining all characteristics with an OR operator.
  • Use a code 'at-least' to indicate that at least n of the characteristics must be met. Use Group.combinationThreshold to specify the value of n.
  • Use a code 'at-most' to indicate that at most n of the characteristics must be met. Use Group.combinationThreshold to specify the value of n.
  • Use a code 'except-subset' to indicate that the characteristics expressed as exclusion criteria are used as exceptions to meeting the characteristics expressed as inclusion criteria. Explaining by example: “Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years” (Example of Group for Cancer Except Subset).

8.3.1.2.3 Group.combinationThreshold

Provides the value of "n" when "at-least" or "at-most" codes are used for Group.combinationMethod (see above)

8.3.1.2.4 Group.characteristic.code

Each characteristic must have a code value (CodeableConcept datatype) to specify the attribute. For instance:

  • for a characteristic of "age > 18 years” the attribute is “age” and the attribute of age may be expressed as

"code": { "coding": [ { "system": "http://snomed.info/sct", "code": "397669002", "display": "Age" } ] }

  • for a characteristic of "Body mass index >= 30 kg/m2" the attribute is "Body mass index" and the attribute may be expressed as

"code": { "coding": [ { "system": "http://loinc.org", "code": "39156-5", "display": "Body mass index (BMI) [Ratio]" } ] }

8.3.1.2.5 Group.characteristic.value[x]

Each characteristic must have a value[x] value to specify the value of the attribute that holds for members of the group. There is no [x] in the JSON or XML expression as it is replaced with the data type (CodeableConcept, boolean, Quantity, Range, Reference, uri, or Expression)

For instance:

  • for a characteristic of "age > 18 years” the value is “> 18 years” and the value may be expressed with a Quantity datatype as

"valueQuantity": { "comparator": ">=", "value": 18, "unit": "years",

"system": "http://unitsofmeasure.org", "code": "a" }

  • for a characteristic of "Body mass index >= 30 kg/m2" the value is ">= 30 kg/m2" and the value may be expressed as

"valueQuantity": { "comparator": ">=", "value": 30, "unit": "kg/m2",

"system": "http://unitsofmeasure.org", "code": "kg/m2" }

8.3.1.2.6 Group.characteristic.exclude

Sometimes group membership is determined by characteristics not possessed. When this is the case, the Group.characteristic.exclude element has a value of true ("exclude": true). For characteristics that are not exclusion criteria, the Group.characteristic.exclude element has a value of false ("exclude": false). The exclude element is required.

For example, an exclusion criterion of HbA1c ≥ 14.0% is expressed as:

{ "description": "HbA1c ≥ 14.0%", "code": {; "coding": [ { "system": "http://loinc.org", "code": "59261-8", "display": "Hemoglobin A1c/Hemoglobin.total in Blood" } ] }, "valueQuantity": { "value": 14, "comparator": ">=", "unit": "%", "system": "http://unitsofmeasure.org", "code": "%" }, "exclude": true }

8.3.1.2.7 Group.characteristic.description

A short, natural language description of the characteristic (using the markdown datatype) that could be used to communicate the criteria to an end-user. The description element is for convenience so that end users can understand the characteristic and is neither a required part of the characteristic nor part of the structured representation of the characteristic.

8.3.1.2.8 Group.characteristic.method

The method modifies the Group.characteristic.code and indicates how the value is to be determined, using the CodeableConcept datatype. For example, HbA1C values can be determined by High-Performance Liquid Chromatography or by Capillary electrophoresis.

The method may be expressed as multiple concepts, eg. standing barefoot for Height measurements could be expressed as two separate concepts (standing, barefoot) that express the method.

8.3.1.2.9 Group.characteristic.formula

The formula modifies the Group.characteristic.code and indicates how the value is to be determined, using an Expression datatype.

8.3.1.2.10 Group.characteristic.determiner

The determiner modifies the Group.characteristic.code and indicates who or what determines the value, using a Reference datatype. The determiner value may reference a person (Practitioner or PractitionerRole Resource) or group (Organization Resource) or device. The reference to a device can be either to a specific device using the Device Resource, or the DeviceMetric Resource if a specific set of device parameters is needed, or a type of device using the DeviceDefinition Resource.

8.3.1.2.11 Group.characteristic.offset

Defines the reference point for comparison when other than 0. As an example, to express a characteristic of a calcium level greater than the normal limit or a hemoglobin level less than 1 g/dL below the reference range, the offset concept would represent "normal limit" or "reference range".

This is a modifier element because it modifies the meaning of the characteristic.value[x].

8.3.1.2.12 Group.characteristic.instances[x]

Number of occurrences meeting the characteristic.

There should be a constraint on the Quantity.value and Range.low.value and Range.high.value that it can only be non-negative whole numbers.

8.3.1.2.13 Group.characteristic.duration[x]

Length of time in which the characteristic is met.

8.3.1.2.14 Group.characteristic.period

The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.

8.3.1.2.15 Group.characteristic.timing

The relative time in which the characteristic is tested, eg. within a month following patient discharge.

Note: RelativeTime is a recent addition to the Group Resource. RelativeTime is used to express a point in time or an interval of time relative to an event defined in data types other than dateTime.

Example: Example of Group for HbA1c at 12 months

Example includes timing and offset "At 12 months form inclusion in a clinical trial. Inclusion is defined as enrollment via the SNOMED code.

"timing": [ { "contextCode": { "coding": [ { "system": "http://snomed.info/sct", "code": "709491003", "display": "Enrollment in clinical trial" } ] }, "offsetDuration": { "value": 12, "unit": "months", "system": "http://unitsofmeasure.org", "code": "mo" }, "text": "at 12 months" }

8.3.2 Boundaries and Relationships

There are a number of mechanisms in FHIR for communicating collections of resources:

  • The List resource - enumerates a flat collection of resources and provides features for managing the collection. While a particular List instance may represent a "snapshot", from a business process perspective the notion of "List" is dynamic – items are added and removed over time. The List resource references other resources. Lists may be curated and have specific business meaning. For use cases where Group is suitable (e.g. for a list of Patients to be viewed on a dashboard), the Group resource should be preferred to the List resource. The underlying rationale is that a collection of patients, practitioners, etc. is likely to be of interest as the subject of a measure, observation, communication, etc., which Group is intended to support.
  • This Group resource - defines a group of specific people, animals, devices etc. by enumerating them, or by describing qualities that group members have. The group resource refers to other resources, possibly implicitly. Groups are intended to be acted upon or observed as a whole; e.g. performing therapy on a group, calculating risk for a group, etc. This resource will commonly be used for public health (e.g. describing an at-risk population), clinical trials (e.g. defining a test subject pool) and similar purposes. It may be used to define families or households, which in some circumstances may act collectively or have a degree of legal or formal recognition.
  • The Organization resource is used for collections of people that have come together to achieve an objective. In generally, the Group resource is used to identify a collection of people (or animals, devices, etc.) that are gathered for the purpose of analysis or acting upon, but are not expected to act themselves. Families or households are sometimes an exceptiont to this, in that they are primarily recipients of care, particularly in a public health context, but sometimes act collectively
  • CareTeam. Group is distinct from CareTeam. Group is patient-independent and identifies an undifferentiated set of individuals who are intended to be the target of one or more clinical activities (e.g. set of clinical trial participants, set of individuals impacted by or at risk of a public health event, a herd or flock, etc.) The CareTeam resource establishes a set of relationships and roles and is specific to a particular Patient. The actors are the individual members or organized group of individuals. CareTeam can be referenced by EpisodeOfCare, Encounter, or CarePlan to identify the set of individuals (and their respective roles) who are intended to be involved in providing the care defined by those resources. Groups containing practitioners are not allowed to perform actions for patient care.
  • The Bundle resource - is an infrastructure container for a group of resources. It does not have narrative and is used to group collections of resources for transmission, persistence or processing (e.g. messages, documents, transactions, query responses, etc.) The content of bundles is typically algorithmically determined for a particular exchange or persistence purpose.
  • The Composition resource - defines a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. The composition resource provides the basic structure of a FHIR document. The full content of the document is expressed using a bundle. Compositions will often reference Lists as the focus of particular sections.
  • The DomainResource.contained element - allows multiple resources to be nested inside any DomainResource. This is a special type of grouping where the grouped resources lose independent existence - they no longer have their own identifiers, can't easily be queried independently, etc. Use of this grouping is a technical mechanism for managing the independence of resources and has no impact on meaning.

8.3.3 References to this Resource

8.3.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Group N DomainResource Group of multiple entities
+ Rule: Group.type SHALL be defined if Group.membership is either 'definitional' or 'enumerated'

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
Interfaces Implemented: CanonicalResource
... url ΣC 0..1 uri Canonical identifier for this Group, represented as an absolute URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Business Identifier for this Group

... version Σ 0..1 string Business version of the Group
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name Σ 0..1 string Label for Group
... title Σ 0..1 string Name for this Group (human friendly)
... status ?!Σ 0..1 code draft | active | retired | unknown
Binding: PublicationStatus (Required)
... experimental Σ 0..1 boolean For testing only - never for real usage
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher

... description 0..1 markdown Natural language description of the group
... useContext Σ 0..* UsageContext The context that the content is intended to support

... purpose 0..1 markdown Why this Group is defined
... copyright 0..1 markdown Notice about intellectual property ownership, can include restrictions on use
... copyrightLabel T 0..1 string Copyright holder and year(s)
... type ΣC 0..1 code person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
Binding: Group Type (Required)
... membership ΣC 1..1 code definitional | conceptual | enumerated
Binding: Group Membership Basis (Required)
... code Σ 0..1 CodeableConcept Use of the Group (and by implication, kind of members)
Binding: Group Code (Extensible)
... quantity Σ 0..1 unsignedInt Number of members
... managingEntity Σ 0..1 Reference(Organization | RelatedPerson | Practitioner | PractitionerRole) Entity that is the custodian of the Group's definition
... combinationMethod ?!Σ 0..1 code all-of | any-of | at-least | at-most | except-subset
Binding: Group Characteristic Combination (Required)
... combinationThreshold 0..1 positiveInt Provides the value of "n" when "at-least" or "at-most" codes are used
... characteristic Σ 0..* BackboneElement Include / Exclude group members by Trait

.... code Σ 1..1 CodeableConcept Kind of characteristic
Binding: Example Characteristic Codes (Example)
.... value[x] Σ 1..1 Value held by characteristic
..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference()
..... valueUri uri
..... valueExpression Expression
.... exclude Σ 1..1 boolean Group includes or excludes
.... description 0..1 markdown Natural language description of the characteristic
.... method 0..* CodeableConcept Method for how the characteristic value was determined
Binding: Definition Method (Example)

.... formula 0..1 Expression Formal algorithm to derive the value
.... determiner 0..1 Reference(Practitioner | PractitionerRole | Organization | Device | DeviceDefinition) Who determines the value
.... offset ?!Σ 0..1 CodeableConcept Reference point for comparison
Binding: Characteristic Offset (Example)
.... instances[x] C 0..1 Number of occurrences meeting the characteristic
+ Rule: Ranges have to be positive
..... instancesUnsignedInt unsignedInt
..... instancesRange Range
.... duration[x] 0..1 Length of time in which the characteristic is met
..... durationDuration Duration
..... durationRange Range
.... period 0..1 Period Period over which characteristic is tested
.... timing 0..* RelativeTime Timing in which the characteristic is determined

... member 0..* BackboneElement Who or what is in group

.... entity 1..1 Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Medication | MedicinalProductDefinition | Substance | SubstanceDefinition | BiologicallyDerivedProduct | NutritionProduct) Reference to the group member
.... involvement 0..* CodeableConcept Code that describes how user is part of the group
Binding: Group Involvement (Example)

.... period 0..1 Period Period member belonged to the group
.... inactive 0..1 boolean If member is no longer in group

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

Group (DomainResource) +CanonicalResourceAn absolute URI that is used to identify this Group when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this Group is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the Group is stored on different serversurl : uri [0..1]Business identifiers assigned to this participant by one of the applications involved. These identifiers remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The identifier that is used to identify this version of the Group when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the Group author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence without additional knowledgeversion : string [0..1]Indicates the mechanism used to compare versions to determine which is more currentversionAlgorithm[x] : DataType [0..1] « string|Coding; null (Strength=Extensible) VersionAlgorithm+ »A label assigned to the group for human identification and communicationname : string [0..1]A short, descriptive, user-friendly title for the Grouptitle : string [0..1]The current state of this Group (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)PublicationStatus! »A Boolean value to indicate that this Group is authored for testing purposes (or education/evaluation/marketing) and no version of this resource will ever be intended for genuine usageexperimental : boolean [0..1]The date (and optionally time) when the Group was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the Group changesdate : dateTime [0..1]The name of the organization or individual responsible for the release and ongoing maintenance of the Grouppublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]Explanation of what the group represents and how it is intended to be useddescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate GroupsuseContext : UsageContext [0..*]Explanation of why this Group is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the Group and/or its contents. Copyright statements are notices of intellectual property ownership and can include restrictions on the use and publishing of the Groupcopyright : markdown [0..1]A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are restricted. (e.g. 'All rights reserved', 'Some rights reserved')copyrightLabel : string [0..1]Identifies the broad classification of the kind of resources the group includestype : code [0..1] « null (Strength=Required)GroupType! » « This element has or is affected by some invariantsC »Basis for membership in the Group: * 'definitional': The Group.characteristics specified are both necessary and sufficient to determine membership. All entities that meet the criteria are considered to be members of the group, whether referenced by the group or not. If members are present, they are individuals that happen to be known as meeting the Group.characteristics. The list cannot be presumed to be complete. * 'conceptual': The Group.characteristics specified are both necessary and sufficient to determine membership. The 'conceptual' Group is a 'definitional' Group in which the Group.type is not bound to FHIR types. * 'enumerated': The Group.characteristics are necessary but not sufficient to determine membership. Membership is determined by being listed as one of the Group.membermembership : code [1..1] « null (Strength=Required)GroupMembershipBasis! » « This element has or is affected by some invariantsC »A code that describes the use of the group. The use of the group usually dictates what kind of entities can be members of the groupcode : CodeableConcept [0..1] « null (Strength=Extensible)GroupCode+ »A count of the number of resource instances that are part of the groupquantity : unsignedInt [0..1]Entity responsible for defining and maintaining Group characteristics and/or registered membersmanagingEntity : Reference [0..1] « Organization|RelatedPerson| Practitioner|PractitionerRole »Used to specify how two or more characteristics are combined (this element modifies the meaning of other elements)combinationMethod : code [0..1] « null (Strength=Required)GroupCharacteristicCombination! »Provides the value of "n" when "at-least" or "at-most" codes are used for combinationMethodcombinationThreshold : positiveInt [0..1]CharacteristicA code that identifies the kind of trait being assertedcode : CodeableConcept [1..1] « null (Strength=Example)ExampleCharacteristicCodes?? »The value of the trait that holds (or does not hold - see 'exclude') for members of the groupvalue[x] : DataType [1..1] « CodeableConcept|boolean|Quantity|Range| Reference|uri|Expression »If true, indicates the characteristic is one that is NOT held by members of the groupexclude : boolean [1..1]A short, natural language description of the characteristic that could be used to communicate the criteria to an end-userdescription : markdown [0..1]Method for how the characteristic value was determinedmethod : CodeableConcept [0..*] « null (Strength=Example)DefinitionMethod?? »A CQL, FHIRPath, or other expression that is used to generate the value for this characteristicformula : Expression [0..1]The entity who is expected to evaluate the characteristic value for candidate group membersdeterminer : Reference [0..1] « Practitioner|PractitionerRole| Organization|Device|DeviceDefinition »Defines the reference point for comparison when other than 0 (this element modifies the meaning of other elements)offset : CodeableConcept [0..1] « null (Strength=Example)CharacteristicOffset?? »Number of occurrences meeting the characteristicinstances[x] : DataType [0..1] « unsignedInt|Range »Length of time in which the characteristic is metduration[x] : DataType [0..1] « Duration|Range »The period over which the characteristic is tested; e.g. the patient had an operation during the month of Juneperiod : Period [0..1]Timing in which the characteristic is determinedtiming : RelativeTime [0..*]MemberA reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the sameentity : Reference [1..1] « CareTeam|Device|Group|HealthcareService| Location|Organization|Patient|Practitioner|PractitionerRole| RelatedPerson|Specimen|Medication|MedicinalProductDefinition| Substance|SubstanceDefinition|BiologicallyDerivedProduct| NutritionProduct »A code that describes how a user is involved in the group. Some groups (e.g. exposure-group) typically don't have variance between members, or it is not tracked, while for other groups (e.g. family, household) this may be meaningfulinvolvement : CodeableConcept [0..*] « null (Strength=Example)GroupInvolvement?? »The period that the member was in the group, if knownperiod : Period [0..1]A flag to indicate that the member is no longer in the group, but previously may have been a memberinactive : boolean [0..1]Identifies traits whose presence r absence is shared by members of the groupcharacteristic[0..*]Identifies the resource instances that are members of the groupmember[0..*]

XML Template

<Group xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this Group, represented as an absolute URI (globally unique) -->
 <identifier><!-- 0..* Identifier Business Identifier for this Group --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the Group -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- 0..1 Label for Group -->
 <title value="[string]"/><!-- 0..1 Name for this Group (human friendly) -->
 <status value="[code]"/><!-- 0..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing only - never for real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the group -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <purpose value="[markdown]"/><!-- 0..1 Why this Group is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Notice about intellectual property ownership, can include restrictions on use -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <type value="[code]"/><!-- I 0..1 person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct -->
 <membership value="[code]"/><!-- I 1..1 definitional | conceptual | enumerated -->
 <code><!-- 0..1 CodeableConcept Use of the Group (and by implication, kind of members) --></code>
 <quantity value="[unsignedInt]"/><!-- 0..1 Number of members -->
 <managingEntity><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) Entity that is the custodian of the Group's definition --></managingEntity>
 <combinationMethod value="[code]"/><!-- 0..1 all-of | any-of | at-least | at-most | except-subset -->
 <combinationThreshold value="[positiveInt]"/><!-- 0..1 Provides the value of "n" when "at-least" or "at-most" codes are used -->
 <characteristic>  <!-- 0..* Include / Exclude group members by Trait -->
  <code><!-- 1..1 CodeableConcept Kind of characteristic --></code>
  <value[x]><!-- 1..1 CodeableConcept|boolean|Quantity|Range|Reference|uri|
    Expression Value held by characteristic --></value[x]>
  <exclude value="[boolean]"/><!-- 1..1 Group includes or excludes -->
  <description value="[markdown]"/><!-- 0..1 Natural language description of the characteristic -->
  <method><!-- 0..* CodeableConcept Method for how the characteristic value was determined --></method>
  <formula><!-- 0..1 Expression Formal algorithm to derive the value --></formula>
  <determiner><!-- 0..1 Reference(Device|DeviceDefinition|Organization|
    Practitioner|PractitionerRole) Who determines the value --></determiner>
  <offset><!-- 0..1 CodeableConcept Reference point for comparison --></offset>
  <instances[x]><!-- 0..1 unsignedInt|Range Number of occurrences meeting the characteristic --></instances[x]>
  <duration[x]><!-- 0..1 Duration|Range Length of time in which the characteristic is met --></duration[x]>
  <period><!-- 0..1 Period Period over which characteristic is tested --></period>
  <timing><!-- 0..* RelativeTime Timing in which the characteristic is determined --></timing>
 </characteristic>
 <member>  <!-- 0..* Who or what is in group -->
  <entity><!-- 1..1 Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|
    HealthcareService|Location|Medication|MedicinalProductDefinition|
    NutritionProduct|Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson|Specimen|Substance|SubstanceDefinition) Reference to the group member --></entity>
  <involvement><!-- 0..* CodeableConcept Code that describes how user is part of the group --></involvement>
  <period><!-- 0..1 Period Period member belonged to the group --></period>
  <inactive value="[boolean]"/><!-- 0..1 If member is no longer in group -->
 </member>
</Group>

JSON Template

{doco
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this Group, represented as an absolute URI (globally unique)
  "identifier" : [{ Identifier }], // Business Identifier for this Group
  "version" : "<string>", // Business version of the Group
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // Label for Group
  "title" : "<string>", // Name for this Group (human friendly)
  "status" : "<code>", // draft | active | retired | unknown
  "experimental" : <boolean>, // For testing only - never for real usage
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the group
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "purpose" : "<markdown>", // Why this Group is defined
  "copyright" : "<markdown>", // Notice about intellectual property ownership, can include restrictions on use
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "type" : "<code>", // I person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
  "membership" : "<code>", // I R!  definitional | conceptual | enumerated
  "code" : { CodeableConcept }, // Use of the Group (and by implication, kind of members)
  "quantity" : "<unsignedInt>", // Number of members
  "managingEntity" : { Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) }, // Entity that is the custodian of the Group's definition
  "combinationMethod" : "<code>", // all-of | any-of | at-least | at-most | except-subset
  "combinationThreshold" : "<positiveInt>", // Provides the value of "n" when "at-least" or "at-most" codes are used
  "characteristic" : [{ // Include / Exclude group members by Trait
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 7:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "valueReference" : { Reference },
    "valueUri" : "<uri>",
    "valueExpression" : { Expression },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "description" : "<markdown>", // Natural language description of the characteristic
    "method" : [{ CodeableConcept }], // Method for how the characteristic value was determined
    "formula" : { Expression }, // Formal algorithm to derive the value
    "determiner" : { Reference(Device|DeviceDefinition|Organization|
    Practitioner|PractitionerRole) }, // Who determines the value
    "offset" : { CodeableConcept }, // Reference point for comparison
    // instances[x]: Number of occurrences meeting the characteristic. One of these 2:
    "instancesUnsignedInt" : "<unsignedInt>",
    "instancesRange" : { Range },
    // duration[x]: Length of time in which the characteristic is met. One of these 2:
    "durationDuration" : { Duration },
    "durationRange" : { Range },
    "period" : { Period }, // Period over which characteristic is tested
    "timing" : [{ RelativeTime }] // Timing in which the characteristic is determined
  }],
  "member" : [{ // Who or what is in group
    "entity" : { Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|
    HealthcareService|Location|Medication|MedicinalProductDefinition|
    NutritionProduct|Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson|Specimen|Substance|SubstanceDefinition) }, // R!  Reference to the group member
    "involvement" : [{ CodeableConcept }], // Code that describes how user is part of the group
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Group;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this Group, represented as an absolute URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for this Group
  fhir:version [ string ] ; # 0..1 Business version of the Group
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:String ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 Label for Group
  fhir:title [ string ] ; # 0..1 Name for this Group (human friendly)
  fhir:status [ code ] ; # 0..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing only - never for real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the group
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Group is defined
  fhir:copyright [ markdown ] ; # 0..1 Notice about intellectual property ownership, can include restrictions on use
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:type [ code ] ; # 0..1 I person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
  fhir:membership [ code ] ; # 1..1 I definitional | conceptual | enumerated
  fhir:code [ CodeableConcept ] ; # 0..1 Use of the Group (and by implication, kind of members)
  fhir:quantity [ unsignedInt ] ; # 0..1 Number of members
  fhir:managingEntity [ Reference(Organization|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Entity that is the custodian of the Group's definition
  fhir:combinationMethod [ code ] ; # 0..1 all-of | any-of | at-least | at-most | except-subset
  fhir:combinationThreshold [ positiveInt ] ; # 0..1 Provides the value of "n" when "at-least" or "at-most" codes are used
  fhir:characteristic ( [ # 0..* Include / Exclude group members by Trait
    fhir:code [ CodeableConcept ] ; # 1..1 Kind of characteristic
    # value[x] : 1..1 Value held by characteristic. One of these 7
      fhir:value [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:value [  a fhir:Boolean ; boolean ]
      fhir:value [  a fhir:Quantity ; Quantity ]
      fhir:value [  a fhir:Range ; Range ]
      fhir:value [  a fhir:Reference ; Reference ]
      fhir:value [  a fhir:Uri ; uri ]
      fhir:value [  a fhir:Expression ; Expression ]
    fhir:exclude [ boolean ] ; # 1..1 Group includes or excludes
    fhir:description [ markdown ] ; # 0..1 Natural language description of the characteristic
    fhir:method  ( [ CodeableConcept ] ... ) ; # 0..* Method for how the characteristic value was determined
    fhir:formula [ Expression ] ; # 0..1 Formal algorithm to derive the value
    fhir:determiner [ Reference(Device|DeviceDefinition|Organization|Practitioner|PractitionerRole) ] ; # 0..1 Who determines the value
    fhir:offset [ CodeableConcept ] ; # 0..1 Reference point for comparison
    # instances[x] : 0..1 Number of occurrences meeting the characteristic. One of these 2
      fhir:instances [  a fhir:UnsignedInt ; unsignedInt ]
      fhir:instances [  a fhir:Range ; Range ]
    # duration[x] : 0..1 Length of time in which the characteristic is met. One of these 2
      fhir:duration [  a fhir:Duration ; Duration ]
      fhir:duration [  a fhir:Range ; Range ]
    fhir:period [ Period ] ; # 0..1 Period over which characteristic is tested
    fhir:timing  ( [ RelativeTime ] ... ) ; # 0..* Timing in which the characteristic is determined
  ] ... ) ;
  fhir:member ( [ # 0..* Who or what is in group
    fhir:entity [ Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|HealthcareService|Location|
  Medication|MedicinalProductDefinition|NutritionProduct|Organization|Patient|
  Practitioner|PractitionerRole|RelatedPerson|Specimen|Substance|
  SubstanceDefinition) ] ; # 1..1 Reference to the group member
    fhir:involvement  ( [ CodeableConcept ] ... ) ; # 0..* Code that describes how user is part of the group
    fhir:period [ Period ] ; # 0..1 Period member belonged to the group
    fhir:inactive [ boolean ] ; # 0..1 If member is no longer in group
  ] ... ) ;
]

Changes from both R4 and R4B

Group
Group.url
  • Added Element
Group.version
  • Added Element
Group.versionAlgorithm[x]
  • Added Element
Group.title
  • Added Element
Group.status
  • Added Element
Group.experimental
  • Added Element
Group.date
  • Added Element
Group.publisher
  • Added Element
Group.contact
  • Added Element
Group.description
  • Added Element
Group.useContext
  • Added Element
Group.purpose
  • Added Element
Group.copyright
  • Added Element
Group.copyrightLabel
  • Added Element
Group.type
  • Min Cardinality changed from 1 to 0
  • Add codes careteam, healthcareservice, location, organization, relatedperson, specimen, medicinalproductdefinition, substancedefinition, biologicallyDerivedProduct, nutritionProduct
Group.membership
  • Added Mandatory Element
Group.code
  • Add Binding `http://hl7.org/fhir/ValueSet/group-code` (extensible)
Group.combinationMethod
  • Added Element
Group.combinationThreshold
  • Added Element
Group.characteristic.value[x]
  • Add Types uri, Expression
Group.characteristic.description
  • Added Element
Group.characteristic.method
  • Added Element
Group.characteristic.formula
  • Added Element
Group.characteristic.determiner
  • Added Element
Group.characteristic.offset
  • Added Element
Group.characteristic.instances[x]
  • Added Element
Group.characteristic.duration[x]
  • Added Element
Group.characteristic.timing
  • Added Element
Group.member.entity
  • Type Reference: Added Target Types CareTeam, HealthcareService, Location, Organization, RelatedPerson, Specimen, MedicinalProductDefinition, SubstanceDefinition, BiologicallyDerivedProduct, NutritionProduct
Group.member.involvement
  • Added Element
Group.active
  • Deleted
Group.actual
  • Deleted (-> Group.membership)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Group N DomainResource Group of multiple entities
+ Rule: Group.type SHALL be defined if Group.membership is either 'definitional' or 'enumerated'

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
Interfaces Implemented: CanonicalResource
... url ΣC 0..1 uri Canonical identifier for this Group, represented as an absolute URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Business Identifier for this Group

... version Σ 0..1 string Business version of the Group
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name Σ 0..1 string Label for Group
... title Σ 0..1 string Name for this Group (human friendly)
... status ?!Σ 0..1 code draft | active | retired | unknown
Binding: PublicationStatus (Required)
... experimental Σ 0..1 boolean For testing only - never for real usage
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher

... description 0..1 markdown Natural language description of the group
... useContext Σ 0..* UsageContext The context that the content is intended to support

... purpose 0..1 markdown Why this Group is defined
... copyright 0..1 markdown Notice about intellectual property ownership, can include restrictions on use
... copyrightLabel T 0..1 string Copyright holder and year(s)
... type ΣC 0..1 code person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
Binding: Group Type (Required)
... membership ΣC 1..1 code definitional | conceptual | enumerated
Binding: Group Membership Basis (Required)
... code Σ 0..1 CodeableConcept Use of the Group (and by implication, kind of members)
Binding: Group Code (Extensible)
... quantity Σ 0..1 unsignedInt Number of members
... managingEntity Σ 0..1 Reference(Organization | RelatedPerson | Practitioner | PractitionerRole) Entity that is the custodian of the Group's definition
... combinationMethod ?!Σ 0..1 code all-of | any-of | at-least | at-most | except-subset
Binding: Group Characteristic Combination (Required)
... combinationThreshold 0..1 positiveInt Provides the value of "n" when "at-least" or "at-most" codes are used
... characteristic Σ 0..* BackboneElement Include / Exclude group members by Trait

.... code Σ 1..1 CodeableConcept Kind of characteristic
Binding: Example Characteristic Codes (Example)
.... value[x] Σ 1..1 Value held by characteristic
..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference()
..... valueUri uri
..... valueExpression Expression
.... exclude Σ 1..1 boolean Group includes or excludes
.... description 0..1 markdown Natural language description of the characteristic
.... method 0..* CodeableConcept Method for how the characteristic value was determined
Binding: Definition Method (Example)

.... formula 0..1 Expression Formal algorithm to derive the value
.... determiner 0..1 Reference(Practitioner | PractitionerRole | Organization | Device | DeviceDefinition) Who determines the value
.... offset ?!Σ 0..1 CodeableConcept Reference point for comparison
Binding: Characteristic Offset (Example)
.... instances[x] C 0..1 Number of occurrences meeting the characteristic
+ Rule: Ranges have to be positive
..... instancesUnsignedInt unsignedInt
..... instancesRange Range
.... duration[x] 0..1 Length of time in which the characteristic is met
..... durationDuration Duration
..... durationRange Range
.... period 0..1 Period Period over which characteristic is tested
.... timing 0..* RelativeTime Timing in which the characteristic is determined

... member 0..* BackboneElement Who or what is in group

.... entity 1..1 Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Medication | MedicinalProductDefinition | Substance | SubstanceDefinition | BiologicallyDerivedProduct | NutritionProduct) Reference to the group member
.... involvement 0..* CodeableConcept Code that describes how user is part of the group
Binding: Group Involvement (Example)

.... period 0..1 Period Period member belonged to the group
.... inactive 0..1 boolean If member is no longer in group

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

Group (DomainResource) +CanonicalResourceAn absolute URI that is used to identify this Group when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this Group is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the Group is stored on different serversurl : uri [0..1]Business identifiers assigned to this participant by one of the applications involved. These identifiers remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]The identifier that is used to identify this version of the Group when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the Group author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence without additional knowledgeversion : string [0..1]Indicates the mechanism used to compare versions to determine which is more currentversionAlgorithm[x] : DataType [0..1] « string|Coding; null (Strength=Extensible) VersionAlgorithm+ »A label assigned to the group for human identification and communicationname : string [0..1]A short, descriptive, user-friendly title for the Grouptitle : string [0..1]The current state of this Group (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)PublicationStatus! »A Boolean value to indicate that this Group is authored for testing purposes (or education/evaluation/marketing) and no version of this resource will ever be intended for genuine usageexperimental : boolean [0..1]The date (and optionally time) when the Group was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the Group changesdate : dateTime [0..1]The name of the organization or individual responsible for the release and ongoing maintenance of the Grouppublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]Explanation of what the group represents and how it is intended to be useddescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate GroupsuseContext : UsageContext [0..*]Explanation of why this Group is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the Group and/or its contents. Copyright statements are notices of intellectual property ownership and can include restrictions on the use and publishing of the Groupcopyright : markdown [0..1]A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are restricted. (e.g. 'All rights reserved', 'Some rights reserved')copyrightLabel : string [0..1]Identifies the broad classification of the kind of resources the group includestype : code [0..1] « null (Strength=Required)GroupType! » « This element has or is affected by some invariantsC »Basis for membership in the Group: * 'definitional': The Group.characteristics specified are both necessary and sufficient to determine membership. All entities that meet the criteria are considered to be members of the group, whether referenced by the group or not. If members are present, they are individuals that happen to be known as meeting the Group.characteristics. The list cannot be presumed to be complete. * 'conceptual': The Group.characteristics specified are both necessary and sufficient to determine membership. The 'conceptual' Group is a 'definitional' Group in which the Group.type is not bound to FHIR types. * 'enumerated': The Group.characteristics are necessary but not sufficient to determine membership. Membership is determined by being listed as one of the Group.membermembership : code [1..1] « null (Strength=Required)GroupMembershipBasis! » « This element has or is affected by some invariantsC »A code that describes the use of the group. The use of the group usually dictates what kind of entities can be members of the groupcode : CodeableConcept [0..1] « null (Strength=Extensible)GroupCode+ »A count of the number of resource instances that are part of the groupquantity : unsignedInt [0..1]Entity responsible for defining and maintaining Group characteristics and/or registered membersmanagingEntity : Reference [0..1] « Organization|RelatedPerson| Practitioner|PractitionerRole »Used to specify how two or more characteristics are combined (this element modifies the meaning of other elements)combinationMethod : code [0..1] « null (Strength=Required)GroupCharacteristicCombination! »Provides the value of "n" when "at-least" or "at-most" codes are used for combinationMethodcombinationThreshold : positiveInt [0..1]CharacteristicA code that identifies the kind of trait being assertedcode : CodeableConcept [1..1] « null (Strength=Example)ExampleCharacteristicCodes?? »The value of the trait that holds (or does not hold - see 'exclude') for members of the groupvalue[x] : DataType [1..1] « CodeableConcept|boolean|Quantity|Range| Reference|uri|Expression »If true, indicates the characteristic is one that is NOT held by members of the groupexclude : boolean [1..1]A short, natural language description of the characteristic that could be used to communicate the criteria to an end-userdescription : markdown [0..1]Method for how the characteristic value was determinedmethod : CodeableConcept [0..*] « null (Strength=Example)DefinitionMethod?? »A CQL, FHIRPath, or other expression that is used to generate the value for this characteristicformula : Expression [0..1]The entity who is expected to evaluate the characteristic value for candidate group membersdeterminer : Reference [0..1] « Practitioner|PractitionerRole| Organization|Device|DeviceDefinition »Defines the reference point for comparison when other than 0 (this element modifies the meaning of other elements)offset : CodeableConcept [0..1] « null (Strength=Example)CharacteristicOffset?? »Number of occurrences meeting the characteristicinstances[x] : DataType [0..1] « unsignedInt|Range »Length of time in which the characteristic is metduration[x] : DataType [0..1] « Duration|Range »The period over which the characteristic is tested; e.g. the patient had an operation during the month of Juneperiod : Period [0..1]Timing in which the characteristic is determinedtiming : RelativeTime [0..*]MemberA reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the sameentity : Reference [1..1] « CareTeam|Device|Group|HealthcareService| Location|Organization|Patient|Practitioner|PractitionerRole| RelatedPerson|Specimen|Medication|MedicinalProductDefinition| Substance|SubstanceDefinition|BiologicallyDerivedProduct| NutritionProduct »A code that describes how a user is involved in the group. Some groups (e.g. exposure-group) typically don't have variance between members, or it is not tracked, while for other groups (e.g. family, household) this may be meaningfulinvolvement : CodeableConcept [0..*] « null (Strength=Example)GroupInvolvement?? »The period that the member was in the group, if knownperiod : Period [0..1]A flag to indicate that the member is no longer in the group, but previously may have been a memberinactive : boolean [0..1]Identifies traits whose presence r absence is shared by members of the groupcharacteristic[0..*]Identifies the resource instances that are members of the groupmember[0..*]

XML Template

<Group xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this Group, represented as an absolute URI (globally unique) -->
 <identifier><!-- 0..* Identifier Business Identifier for this Group --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the Group -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- 0..1 Label for Group -->
 <title value="[string]"/><!-- 0..1 Name for this Group (human friendly) -->
 <status value="[code]"/><!-- 0..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing only - never for real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the group -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <purpose value="[markdown]"/><!-- 0..1 Why this Group is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Notice about intellectual property ownership, can include restrictions on use -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <type value="[code]"/><!-- I 0..1 person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct -->
 <membership value="[code]"/><!-- I 1..1 definitional | conceptual | enumerated -->
 <code><!-- 0..1 CodeableConcept Use of the Group (and by implication, kind of members) --></code>
 <quantity value="[unsignedInt]"/><!-- 0..1 Number of members -->
 <managingEntity><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) Entity that is the custodian of the Group's definition --></managingEntity>
 <combinationMethod value="[code]"/><!-- 0..1 all-of | any-of | at-least | at-most | except-subset -->
 <combinationThreshold value="[positiveInt]"/><!-- 0..1 Provides the value of "n" when "at-least" or "at-most" codes are used -->
 <characteristic>  <!-- 0..* Include / Exclude group members by Trait -->
  <code><!-- 1..1 CodeableConcept Kind of characteristic --></code>
  <value[x]><!-- 1..1 CodeableConcept|boolean|Quantity|Range|Reference|uri|
    Expression Value held by characteristic --></value[x]>
  <exclude value="[boolean]"/><!-- 1..1 Group includes or excludes -->
  <description value="[markdown]"/><!-- 0..1 Natural language description of the characteristic -->
  <method><!-- 0..* CodeableConcept Method for how the characteristic value was determined --></method>
  <formula><!-- 0..1 Expression Formal algorithm to derive the value --></formula>
  <determiner><!-- 0..1 Reference(Device|DeviceDefinition|Organization|
    Practitioner|PractitionerRole) Who determines the value --></determiner>
  <offset><!-- 0..1 CodeableConcept Reference point for comparison --></offset>
  <instances[x]><!-- 0..1 unsignedInt|Range Number of occurrences meeting the characteristic --></instances[x]>
  <duration[x]><!-- 0..1 Duration|Range Length of time in which the characteristic is met --></duration[x]>
  <period><!-- 0..1 Period Period over which characteristic is tested --></period>
  <timing><!-- 0..* RelativeTime Timing in which the characteristic is determined --></timing>
 </characteristic>
 <member>  <!-- 0..* Who or what is in group -->
  <entity><!-- 1..1 Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|
    HealthcareService|Location|Medication|MedicinalProductDefinition|
    NutritionProduct|Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson|Specimen|Substance|SubstanceDefinition) Reference to the group member --></entity>
  <involvement><!-- 0..* CodeableConcept Code that describes how user is part of the group --></involvement>
  <period><!-- 0..1 Period Period member belonged to the group --></period>
  <inactive value="[boolean]"/><!-- 0..1 If member is no longer in group -->
 </member>
</Group>

JSON Template

{doco
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this Group, represented as an absolute URI (globally unique)
  "identifier" : [{ Identifier }], // Business Identifier for this Group
  "version" : "<string>", // Business version of the Group
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // Label for Group
  "title" : "<string>", // Name for this Group (human friendly)
  "status" : "<code>", // draft | active | retired | unknown
  "experimental" : <boolean>, // For testing only - never for real usage
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the group
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "purpose" : "<markdown>", // Why this Group is defined
  "copyright" : "<markdown>", // Notice about intellectual property ownership, can include restrictions on use
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "type" : "<code>", // I person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
  "membership" : "<code>", // I R!  definitional | conceptual | enumerated
  "code" : { CodeableConcept }, // Use of the Group (and by implication, kind of members)
  "quantity" : "<unsignedInt>", // Number of members
  "managingEntity" : { Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) }, // Entity that is the custodian of the Group's definition
  "combinationMethod" : "<code>", // all-of | any-of | at-least | at-most | except-subset
  "combinationThreshold" : "<positiveInt>", // Provides the value of "n" when "at-least" or "at-most" codes are used
  "characteristic" : [{ // Include / Exclude group members by Trait
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 7:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "valueReference" : { Reference },
    "valueUri" : "<uri>",
    "valueExpression" : { Expression },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "description" : "<markdown>", // Natural language description of the characteristic
    "method" : [{ CodeableConcept }], // Method for how the characteristic value was determined
    "formula" : { Expression }, // Formal algorithm to derive the value
    "determiner" : { Reference(Device|DeviceDefinition|Organization|
    Practitioner|PractitionerRole) }, // Who determines the value
    "offset" : { CodeableConcept }, // Reference point for comparison
    // instances[x]: Number of occurrences meeting the characteristic. One of these 2:
    "instancesUnsignedInt" : "<unsignedInt>",
    "instancesRange" : { Range },
    // duration[x]: Length of time in which the characteristic is met. One of these 2:
    "durationDuration" : { Duration },
    "durationRange" : { Range },
    "period" : { Period }, // Period over which characteristic is tested
    "timing" : [{ RelativeTime }] // Timing in which the characteristic is determined
  }],
  "member" : [{ // Who or what is in group
    "entity" : { Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|
    HealthcareService|Location|Medication|MedicinalProductDefinition|
    NutritionProduct|Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson|Specimen|Substance|SubstanceDefinition) }, // R!  Reference to the group member
    "involvement" : [{ CodeableConcept }], // Code that describes how user is part of the group
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Group;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this Group, represented as an absolute URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for this Group
  fhir:version [ string ] ; # 0..1 Business version of the Group
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:String ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 Label for Group
  fhir:title [ string ] ; # 0..1 Name for this Group (human friendly)
  fhir:status [ code ] ; # 0..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing only - never for real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the group
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Group is defined
  fhir:copyright [ markdown ] ; # 0..1 Notice about intellectual property ownership, can include restrictions on use
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:type [ code ] ; # 0..1 I person | animal | practitioner | device | careteam | healthcareservice | location | organization | relatedperson | specimen | medication | medicinalproductdefinition | substance | substancedefinition | biologicallyDerivedProduct | nutritionProduct
  fhir:membership [ code ] ; # 1..1 I definitional | conceptual | enumerated
  fhir:code [ CodeableConcept ] ; # 0..1 Use of the Group (and by implication, kind of members)
  fhir:quantity [ unsignedInt ] ; # 0..1 Number of members
  fhir:managingEntity [ Reference(Organization|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Entity that is the custodian of the Group's definition
  fhir:combinationMethod [ code ] ; # 0..1 all-of | any-of | at-least | at-most | except-subset
  fhir:combinationThreshold [ positiveInt ] ; # 0..1 Provides the value of "n" when "at-least" or "at-most" codes are used
  fhir:characteristic ( [ # 0..* Include / Exclude group members by Trait
    fhir:code [ CodeableConcept ] ; # 1..1 Kind of characteristic
    # value[x] : 1..1 Value held by characteristic. One of these 7
      fhir:value [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:value [  a fhir:Boolean ; boolean ]
      fhir:value [  a fhir:Quantity ; Quantity ]
      fhir:value [  a fhir:Range ; Range ]
      fhir:value [  a fhir:Reference ; Reference ]
      fhir:value [  a fhir:Uri ; uri ]
      fhir:value [  a fhir:Expression ; Expression ]
    fhir:exclude [ boolean ] ; # 1..1 Group includes or excludes
    fhir:description [ markdown ] ; # 0..1 Natural language description of the characteristic
    fhir:method  ( [ CodeableConcept ] ... ) ; # 0..* Method for how the characteristic value was determined
    fhir:formula [ Expression ] ; # 0..1 Formal algorithm to derive the value
    fhir:determiner [ Reference(Device|DeviceDefinition|Organization|Practitioner|PractitionerRole) ] ; # 0..1 Who determines the value
    fhir:offset [ CodeableConcept ] ; # 0..1 Reference point for comparison
    # instances[x] : 0..1 Number of occurrences meeting the characteristic. One of these 2
      fhir:instances [  a fhir:UnsignedInt ; unsignedInt ]
      fhir:instances [  a fhir:Range ; Range ]
    # duration[x] : 0..1 Length of time in which the characteristic is met. One of these 2
      fhir:duration [  a fhir:Duration ; Duration ]
      fhir:duration [  a fhir:Range ; Range ]
    fhir:period [ Period ] ; # 0..1 Period over which characteristic is tested
    fhir:timing  ( [ RelativeTime ] ... ) ; # 0..* Timing in which the characteristic is determined
  ] ... ) ;
  fhir:member ( [ # 0..* Who or what is in group
    fhir:entity [ Reference(BiologicallyDerivedProduct|CareTeam|Device|Group|HealthcareService|Location|
  Medication|MedicinalProductDefinition|NutritionProduct|Organization|Patient|
  Practitioner|PractitionerRole|RelatedPerson|Specimen|Substance|
  SubstanceDefinition) ] ; # 1..1 Reference to the group member
    fhir:involvement  ( [ CodeableConcept ] ... ) ; # 0..* Code that describes how user is part of the group
    fhir:period [ Period ] ; # 0..1 Period member belonged to the group
    fhir:inactive [ boolean ] ; # 0..1 If member is no longer in group
  ] ... ) ;
]

Changes from both R4 and R4B

Group
Group.url
  • Added Element
Group.version
  • Added Element
Group.versionAlgorithm[x]
  • Added Element
Group.title
  • Added Element
Group.status
  • Added Element
Group.experimental
  • Added Element
Group.date
  • Added Element
Group.publisher
  • Added Element
Group.contact
  • Added Element
Group.description
  • Added Element
Group.useContext
  • Added Element
Group.purpose
  • Added Element
Group.copyright
  • Added Element
Group.copyrightLabel
  • Added Element
Group.type
  • Min Cardinality changed from 1 to 0
  • Add codes careteam, healthcareservice, location, organization, relatedperson, specimen, medicinalproductdefinition, substancedefinition, biologicallyDerivedProduct, nutritionProduct
Group.membership
  • Added Mandatory Element
Group.code
  • Add Binding `http://hl7.org/fhir/ValueSet/group-code` (extensible)
Group.combinationMethod
  • Added Element
Group.combinationThreshold
  • Added Element
Group.characteristic.value[x]
  • Add Types uri, Expression
Group.characteristic.description
  • Added Element
Group.characteristic.method
  • Added Element
Group.characteristic.formula
  • Added Element
Group.characteristic.determiner
  • Added Element
Group.characteristic.offset
  • Added Element
Group.characteristic.instances[x]
  • Added Element
Group.characteristic.duration[x]
  • Added Element
Group.characteristic.timing
  • Added Element
Group.member.entity
  • Type Reference: Added Target Types CareTeam, HealthcareService, Location, Organization, RelatedPerson, Specimen, MedicinalProductDefinition, SubstanceDefinition, BiologicallyDerivedProduct, NutritionProduct
Group.member.involvement
  • Added Element
Group.active
  • Deleted
Group.actual
  • Deleted (-> Group.membership)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) , the spreadsheet version & the dependency analysis

8.3.4.1 Terminology Bindings

Path ValueSet Type Documentation
Group.versionAlgorithm[x] VersionAlgorithm Extensible

Indicates the mechanism used to compare versions to determine which is more current.
Group.status PublicationStatus Required

The lifecycle status of an artifact.
Group.type GroupType Required

Types of resources that are part of group.
Group.membership GroupMembershipBasis Required

Basis for membership in a group
Group.code GroupCode (a valid code from Group Type) Extensible

A code that describes the use of the group. The use of the group usually dictates what kind of entities can be members of the group
Group.combinationMethod GroupCharacteristicCombination Required

Logical grouping of characteristics for the Group Resource.
Group.characteristic.code ExampleCharacteristicCodes Example

This value set contains an example set of LOINC codes that might be used to define common characteristics for grouping individuals in FHIR Group resources.
Group.characteristic.method DefinitionMethod Example

The method used to define, describe, or determine a characteristic value.
Group.characteristic.offset CharacteristicOffset Example

Reference point for characteristic.valueQuantity.
Group.member.involvement GroupInvolvement Example

A code that describes how a member of the group participates in the group.

8.3.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img cnl-1Warning Group.urlURL should not contain | or # - these characters make processing canonical references problematicexists() implies matches('^[^|# ]+$')
img grp-1Rule Group.characteristic.instances[x]Ranges have to be positive($this is Range) implies ((low.empty() or ((low.code.exists() or low.value.empty()) and (low.system.empty() or low.system = %ucum) and (low.code.empty() or low.code = '1') and (low.value.empty() or low.value.hasValue().not() or low.value.toString().contains('.').not()) and (low.value.empty() or low.value.hasValue().not() or low.value >= 0))) and (high.empty() or ((high.code.exists() or high.value.empty()) and (high.system.empty() or high.system = %ucum) and (high.code.empty() or high.code = '1') and (high.value.empty() or high.value.hasValue().not() or high.value.toString().contains('.').not()) and (high.value.empty() or high.value.hasValue().not() or high.value >= 0))))
img grp-2Rule (base)Group.type SHALL be defined if Group.membership is either 'definitional' or 'enumerated'type.exists() or (membership = 'conceptual')

8.3.4.3 Mixing Characteristics and Members

If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.

8.3.4.4 Managing large Groups

For operations to assist in adding to, removing from, or filtering contents of large Groups, see Operations for Large Resources.

8.3.4.5 Membership

Membership testing is used to test for active members of a Group. At a minimum, servers supporting membership testing on Group resources SHALL be able to correctly identify active enumerated entities. Active enumerated entities in a group are entities:

  • listed in Group.member.entity,
  • that do not have Group.member.inactive with a value of true, and
  • do not have an expired Group.member.period (e.g., either the element is not present or has a period covering 'now').

Membership testing MAY also be applied to characteristic-defined Groups. If supported, membership testing is based on the characteristic testing of the Group. Any entity meeting the required characteristics is considered to be active.

Servers SHOULD declare whether they support only the enumerated or characteristic group filters, via CapabilityStatement.rest.resource.documentation in markdown. Servers MAY impose additional membership constraints (e.g. based on modifier extensions).

8.3.4.6 Relationships inside the group

Some systems may track detailed family relationship codes (e.g. child, mother, grandfather) within a group rather than merely saying "family member". There are a few options to support conveying such information:

  • Instances of the PersonalRelationship resource can be used to indicate relationships between group members. Such relationships can be leveraged independent of the participants' involvement of the group
  • More detailed family relationship codes (e.g. from the [Personal Relationship RoleType Valueset](https://terminology.hl7.org/6.0.2/ValueSet-v3-PersonalRelationshipRoleType.html)) MAY be sent as additional Codings in the Group.member.involvement element. These SHOULD also be accompanied by the 'family-member' code to support systems that might not understand more detailed codes. If this is done, then the relationship codes are interpreted as being with respect to whichever group member is designated as "head of household"/"primary contact". If there is no such group member explicitly designated, then the nature of the more detailed personal relationship codes cannot reliably be interpreted.

8.3.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
characteristic token Kind of characteristic Group.characteristic.code
characteristic-quantity composite A composite of both characteristic and quantity values On Group.characteristic:
  characteristic: code
  quantity: (value.ofType(Quantity)) | (value.ofType(Range))
characteristic-reference composite A composite of both characteristic and reference values On Group.characteristic:
  characteristic: code
  reference: value.ofType(Reference))
characteristic-value composite A composite of both characteristic and value On Group.characteristic:
  characteristic: code
  value: (value.ofType(CodeableConcept)) | (value.ofType(boolean))
code token The kind of resources contained Group.code
exclude token Group includes or excludes Group.characteristic.exclude
experimental token Whether the Group is experimental Group.experimental
identifier token Unique id Group.identifier 28 Resources
managing-entity reference Entity that is the custodian of the Group's definition Group.managingEntity
(Practitioner, Organization, PractitionerRole, RelatedPerson)
member reference Reference to the group member Group.member.entity
(Group, SubstanceDefinition, Organization, CareTeam, BiologicallyDerivedProduct, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson, Practitioner, Specimen, MedicinalProductDefinition, NutritionProduct, Medication, Substance, Location)
membership token Definitional or enumerated group Group.membership
name string A portion of the Group's name Group.name 23 Resources
quantity quantity Quantity Value held by characteristic (Group.characteristic.value.ofType(Quantity)) | (Group.characteristic.value.ofType(Range))
status token The current status of the Group Group.status 28 Resources
type token The type of resources the group contains Group.type
url uri The uri that identifies the Group Group.url 29 Resources
value token Value held by characteristic (Group.characteristic.value.ofType(CodeableConcept)) | (Group.characteristic.value.ofType(boolean))