Making Electronic Data More available for Research and Public Health (MedMorph)
1.0.0 - STU 1 United States of America flag

Making Electronic Data More available for Research and Public Health (MedMorph), published by HL7 International - Public Health Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-medmorph/ and changes regularly. See the Directory of published versions

Resource Profile: MedMorphEncounterStartSubscription - Detailed Descriptions

Active as of 2023-06-08

Definitions for the medmorph-encounter-start-subscription resource profile.

Guidance on how to interpret the contents of this table can be found here.

1. Subscription
Definition

Defines a MedMorph Encounter Start Subscription Topic.

The subscription resource is used to define a push-based subscription from a server to another system. Once a subscription is registered with the server, the server checks every resource that is created or updated, and if the resource matches the given criteria, it sends a message on the defined "channel" so that another system can take an appropriate action.

2. Subscription.criteria
Definition

Defines a MedMorph Encounter Start Subscription Topic.

When using topic-based subscriptions, the primary criteria is always the topic, indicated by its canonical URL.

Pattern Valuehttp://hl7.org/fhir/us/medmorph/SubscriptionTopic/encounter-start
3. Subscription.criteria.extension:filterCriteria
SliceNamefilterCriteria
Control0..1
TypeExtension(BackportFilterCriteria) (Extension Type: string)
4. Subscription.criteria.extension:filterCriteria.valueString
Control1..1
Typestring
Pattern ValueEncounter?status=in-progress
5. Subscription.channel
Control0..?
6. Subscription.channel.type
Fixed Valuerest-hook

Guidance on how to interpret the contents of this table can be found here.

1. Subscription
Definition

Defines a MedMorph Encounter Start Subscription Topic.

The subscription resource is used to define a push-based subscription from a server to another system. Once a subscription is registered with the server, the server checks every resource that is created or updated, and if the resource matches the given criteria, it sends a message on the defined "channel" so that another system can take an appropriate action.

Control0..*
Summaryfalse
Alternate NamesWebHook, Hook, Routing Rule
InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Subscription.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. Subscription.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
4. Subscription.status
Definition

The status of the subscription, which marks the server state for managing the subscription.

Control1..1
BindingThe codes SHALL be taken from SubscriptionStatus

The status of a subscription.

Typecode
Is Modifiertrue
Summarytrue
Comments

A client can only submit subscription resources in the requested or off state. Only the server can move a subscription from requested to active, and then to error. Either the server or the client can turn a subscription off.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Subscription.reason
Definition

A description of why this subscription is defined.

Control1..1
Typestring
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Subscription.criteria
Definition

Defines a MedMorph Encounter Start Subscription Topic.

The rules that the server should use to determine when to generate notifications for this subscription.

Control1..1
Typestring
Must Supporttrue
Summarytrue
Comments

The rules are search criteria (without the [base] part). Like Bundle.entry.request.url, it has no leading "/".

Pattern Valuehttp://hl7.org/fhir/us/medmorph/SubscriptionTopic/encounter-start
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Subscription.criteria.extension:filterCriteria
SliceNamefilterCriteria
Definition

Criteria for topic-based filtering (filter-by).

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportFilterCriteria) (Extension Type: string)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
8. Subscription.criteria.extension:filterCriteria.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.criteria.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Subscription.criteria.extension:filterCriteria.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/subscriptions-backport/StructureDefinition/backport-filter-criteria
10. Subscription.criteria.extension:filterCriteria.value[x]
Definition

Search-style filters to be applied to narrow the subscription topic stream. Keys can be either search parameters appropriate to the filtering resource or keys defined within the subscription topic.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Comments

When multiple filters are applied, evaluates to true if all the conditions are met; otherwise it returns false. (i.e., logical AND).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Subscription.criteria.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
11. Subscription.criteria.extension:filterCriteria.value[x]:valueString
SliceNamevalueString
Definition

Search-style filters to be applied to narrow the subscription topic stream. Keys can be either search parameters appropriate to the filtering resource or keys defined within the subscription topic.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Comments

When multiple filters are applied, evaluates to true if all the conditions are met; otherwise it returns false. (i.e., logical AND).

Pattern ValueEncounter?status=in-progress
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Subscription.channel
Definition

Details where to send notifications when resources are received that meet the criteria.

Control1..1
TypeBackboneElement
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
13. Subscription.channel.extension:heartbeatPeriod
SliceNameheartbeatPeriod
Definition

If present, a 'hearbeat' notification (keepalive) is sent via this channel with an the interval period equal to this elements integer value in seconds. If not present, a heartbeat notification is not sent.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportHeartbeatPeriod) (Extension Type: unsignedInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
14. Subscription.channel.extension:timeout
SliceNametimeout
Definition

If present, the maximum amount of time a server will allow before failing a notification attempt.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportTimeout) (Extension Type: unsignedInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Subscription.channel.extension:maxCount
SliceNamemaxCount
Definition

If present, the maximum number of triggering resources that will be included in a notification bundle (e.g., a server will not include more than this number of trigger resources in a single notification). Note that this is not a strict limit on the number of entries in a bundle, as dependent resources can be included.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportMaxCount) (Extension Type: positiveInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Subscription.channel.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
17. Subscription.channel.type
Definition

The type of channel to send notifications on.

Control1..1
BindingThe codes SHALL be taken from SubscriptionChannelType

The type of method used to execute a subscription.

Typecode
Summarytrue
Fixed Valuerest-hook
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Subscription.channel.type.extension:customChannelType
SliceNamecustomChannelType
Definition

The type of channel to send notifications on.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportChannelType) (Extension Type: Coding)
Must Supporttrue
Summarytrue
Comments

This extension allows for the use of additional channel types that were not defined in the FHIR R4 subscription definition.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
19. Subscription.channel.payload
Definition

The mime type to send the payload in - either application/fhir+xml, or application/fhir+json. If the payload is not present, then there is no payload in the notification, just a notification. The mime type "text/plain" may also be used for Email and SMS subscriptions.

Control10..1
BindingThe codes SHALL be taken from Mime Types

BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

The mime type of an attachment. Any valid mime type is allowed.

Typecode
Summarytrue
Comments

Sending the payload has obvious security implications. The server is responsible for ensuring that the content is appropriately secured.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Subscription.channel.payload.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.channel.payload.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
21. Subscription.channel.payload.extension:content
SliceNamecontent
Definition

How much of the resource content to deliver in the notification payload. The choices are an empty payload, only the resource id, or the full resource content.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportPayloadContent) (Extension Type: code)
Must Supporttrue
Summarytrue
Comments

Sending the payload has obvious security implications. The server is responsible for ensuring that the content is appropriately secured.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())

Guidance on how to interpret the contents of this table can be found here.

1. Subscription
Definition

Defines a MedMorph Encounter Start Subscription Topic.

Control0..*
Summaryfalse
Alternate NamesWebHook, Hook, Routing Rule
2. Subscription.id
Definition

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

Control0..1
Typeid
Summarytrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. Subscription.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Subscription.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Subscription.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages IETF language ta
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Summaryfalse
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Subscription.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Subscription.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

InvariantsDefined on this element
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
8. Subscription.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
9. Subscription.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Subscription.status
Definition

The status of the subscription, which marks the server state for managing the subscription.

Control1..1
BindingThe codes SHALL be taken from SubscriptionStatus The status of a subscription
Typecode
Is Modifiertrue
Summarytrue
Comments

A client can only submit subscription resources in the requested or off state. Only the server can move a subscription from requested to active, and then to error. Either the server or the client can turn a subscription off.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Subscription.contact
Definition

Contact details for a human to contact about the subscription. The primary use of this for system administrator troubleshooting.

Control0..*
TypeContactPoint
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Subscription.end
Definition

The time for the server to turn the subscription off.

Control0..1
Typeinstant
Summarytrue
Comments

The server is permitted to deviate from this time but should observe it.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Subscription.reason
Definition

A description of why this subscription is defined.

Control1..1
Typestring
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Subscription.criteria
Definition

Defines a MedMorph Encounter Start Subscription Topic.

Control1..1
Typestring
Must Supporttrue
Summarytrue
Comments

The rules are search criteria (without the [base] part). Like Bundle.entry.request.url, it has no leading "/".

Pattern Valuehttp://hl7.org/fhir/us/medmorph/SubscriptionTopic/encounter-start
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Subscription.criteria.id
Definition

unique id for the element within a resource (for internal references)

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
16. Subscription.criteria.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.criteria.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
17. Subscription.criteria.extension:filterCriteria
SliceNamefilterCriteria
Definition

Criteria for topic-based filtering (filter-by).

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportFilterCriteria) (Extension Type: string)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. Subscription.criteria.extension:filterCriteria.id
Definition

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

Control0..1
Typeid
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
19. Subscription.criteria.extension:filterCriteria.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.criteria.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
20. Subscription.criteria.extension:filterCriteria.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/subscriptions-backport/StructureDefinition/backport-filter-criteria
21. Subscription.criteria.extension:filterCriteria.value[x]
Definition

Search-style filters to be applied to narrow the subscription topic stream. Keys can be either search parameters appropriate to the filtering resource or keys defined within the subscription topic.

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Comments

When multiple filters are applied, evaluates to true if all the conditions are met; otherwise it returns false. (i.e., logical AND).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Subscription.criteria.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
22. Subscription.criteria.extension:filterCriteria.value[x]:valueString
SliceNamevalueString
Definition

Search-style filters to be applied to narrow the subscription topic stream. Keys can be either search parameters appropriate to the filtering resource or keys defined within the subscription topic.

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Comments

When multiple filters are applied, evaluates to true if all the conditions are met; otherwise it returns false. (i.e., logical AND).

Pattern ValueEncounter?status=in-progress
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Subscription.criteria.value
Definition

The actual value

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Max Length1048576
24. Subscription.error
Definition

A record of the last error that occurred when the server processed a notification.

Control0..1
Typestring
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Subscription.channel
Definition

Details where to send notifications when resources are received that meet the criteria.

Control1..1
TypeBackboneElement
Summarytrue
26. Subscription.channel.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
27. Subscription.channel.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.channel.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
28. Subscription.channel.extension:heartbeatPeriod
SliceNameheartbeatPeriod
Definition

If present, a 'hearbeat' notification (keepalive) is sent via this channel with an the interval period equal to this elements integer value in seconds. If not present, a heartbeat notification is not sent.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportHeartbeatPeriod) (Extension Type: unsignedInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
29. Subscription.channel.extension:timeout
SliceNametimeout
Definition

If present, the maximum amount of time a server will allow before failing a notification attempt.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportTimeout) (Extension Type: unsignedInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. Subscription.channel.extension:maxCount
SliceNamemaxCount
Definition

If present, the maximum number of triggering resources that will be included in a notification bundle (e.g., a server will not include more than this number of trigger resources in a single notification). Note that this is not a strict limit on the number of entries in a bundle, as dependent resources can be included.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportMaxCount) (Extension Type: positiveInt)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
31. Subscription.channel.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
32. Subscription.channel.type
Definition

The type of channel to send notifications on.

Control1..1
BindingThe codes SHALL be taken from SubscriptionChannelType The type of method used to execute a subscription
Typecode
Summarytrue
Fixed Valuerest-hook
33. Subscription.channel.type.id
Definition

unique id for the element within a resource (for internal references)

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
34. Subscription.channel.type.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.channel.type.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
35. Subscription.channel.type.extension:customChannelType
SliceNamecustomChannelType
Definition

The type of channel to send notifications on.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportChannelType) (Extension Type: Coding)
Must Supporttrue
Summarytrue
Comments

This extension allows for the use of additional channel types that were not defined in the FHIR R4 subscription definition.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
36. Subscription.channel.type.value
Definition

Primitive value for code

Control0..1
Typecode
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
37. Subscription.channel.endpoint
Definition

The url that describes the actual end-point to send messages to.

Control0..1
Typeurl
Summarytrue
Comments

For rest-hook, and websocket, the end-point must be an http: or https: URL; for email, a mailto: url, for sms, a tel: url, and for message the endpoint can be in any form of url the server understands (usually, http: or mllp:). The URI is allowed to be relative; in which case, it is relative to the server end-point (since there may be more than one, clients should avoid using relative URIs).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Subscription.channel.payload
Definition

The mime type to send the payload in - either application/fhir+xml, or application/fhir+json. If the payload is not present, then there is no payload in the notification, just a notification. The mime type "text/plain" may also be used for Email and SMS subscriptions.

Control1..1
BindingThe codes SHALL be taken from Mime Types BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049
Typecode
Summarytrue
Comments

Sending the payload has obvious security implications. The server is responsible for ensuring that the content is appropriately secured.

39. Subscription.channel.payload.id
Definition

unique id for the element within a resource (for internal references)

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
40. Subscription.channel.payload.extension
Definition

An Extension

Control1..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Subscription.channel.payload.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
41. Subscription.channel.payload.extension:content
SliceNamecontent
Definition

How much of the resource content to deliver in the notification payload. The choices are an empty payload, only the resource id, or the full resource content.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(BackportPayloadContent) (Extension Type: code)
Must Supporttrue
Summarytrue
Comments

Sending the payload has obvious security implications. The server is responsible for ensuring that the content is appropriately secured.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (: hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
42. Subscription.channel.payload.value
Definition

Primitive value for code

Control0..1
Typecode
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
43. Subscription.channel.header
Definition

Additional headers / information to send as part of the notification.

Control0..*
Typestring
Summarytrue
Comments

Exactly what these mean depend on the channel type. They can convey additional information to the recipient and/or meet security requirements; for example, support of multiple headers in the outgoing notifications for rest-hook type subscriptions.

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