Release 5 Draft Ballot

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: Informative

Welcome to the draft ballot for FHIR Release 5 (R5) ballot. The R5 release of FHIR has content with different ballot statuses:

  • Normative: Content that is subject to normative ballot rules. Once passed, strict rules are imposed on future change to help ensure inter-version compatibility
  • Trial Use: Content that is undergoing FHIR maturity Model based testing. In a future ballot cycle, once sufficiently mature, it will be balloted as normative
  • Informative: Content that is advisory (e.g. implementers are not required to conform to the content), or navigational content - tables of contents, generated lists, etc.
  • Draft: Content added late in the balloting process that has no formal standing, but is published for visibility. It might not be suitable for use in production systems.
  • Deprecated: Content that is in the process of being removed (see deprecation).
  • External: Content that is replicated from external standards (e.g. HL7 v2, DICOM) and is not subject to ballot comment. This content is mostly being moved out of the specification now

This is the first step in the FHIR R5 Ballot Process. The draft ballot is the start of the ovrall ballot process for FHIR R5. The intent is to allow the various committees that maintain content to get comments on the overall direction and scope of their content, and to exercise new and updated publishing and voting machinery.

Three ballot periods are anticipated:

Draft Ballot Apr - May 2021 This ballot
Ballot #1 Aug - Sept 2021 The first full R5 ballot, both Normative and Trial Use content, split into multiple ballot packages (the exact details are yet to be resolved)
Follow up Ballot Dec - Jan 2021 If necessary: Reballoting of normative content where required, and significant new or revised Trial Use content

This ballot introduces a number of significant changes that are part of the Release 5:

This ballot is using HL7's new Jira balloting process . As such, ballot comments will need to be submitted in Jira and, in general, balloting spreadsheets will not be used. Some organizational and affiliate balloters may continue to use spreadsheets but will be responsible for importing them into Jira themselves and may have slightly different processes for consolidating ballots to take that into account. The ballot desktop will be used for voter registration but will not be available for vote submission. Voters are encouraged to view the recorded tutorial on Jira balloting in addition to reading through the instructions on submitting Jira feedback and using Jira balloting . A webinar will be held part-way through the ballot cycle to provide an opportunity to ask questions about the process. Questions can also be raised on the Jira/Confluence stream on

Because this is only an draft ballot, committees are not required to response to comment, but will endeavour to do so.

When submitting your ballot feedback, if you have a general comment on something that you see occurring multiple times, please include at least a couple of specific locations where you see the issue. As much as possible, capture each separate concern as a distinct tracker item ; it makes our job of reconciling much easier. Also, don't forget to fill in the section numbers (gray numbers to the left of each heading) and URLs. Only one URL should be placed in the "url" element or column. If you want to reference additional URLs, include them in the text of your ballot comment.

If you have questions that are interfering with the ability to review the specification or submit ballot comments, please contact one of the co-chairs of the FHIR Management Group: Lloyd McKenzie or David Hay.

Thanks for taking the time to review the FHIR specification. We appreciate any feedback you can provide.

The difference analysis in this ballot for resources is still between Release 3 and Release 4. This will be updated when Release 5 is prior to publication of the final specification. In the meantime, balloters are welcome to comment on suggested improvements to the mappings and difference statements, but these cannot be the basis for negative votes. Contributions may also be made directly (join the conversation at ).