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Modeling and Methodology icon Work GroupMaturity Level: NormativeStandards Status: Partially Normative

This page provides the detailed descriptions for the datatypes

Datatypes Index

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

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FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Attachment
Standards StatusThis element has a standards status of "Normative"
Element IdAttachment
Definition

For referring to data content defined in other formats.

Short DisplayContent in a format defined elsewhere
Cardinality0..*
TypeDataType
Requirements

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

Comments

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

Invariants
Defined on this element
att-1Rule If the Attachment has data, it SHALL have a contentTypedata.empty() or contentType.exists()
Attachment.contentType
Element IdAttachment.contentType
Definition

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

Short DisplayMime type of the content, with charset etc.
Cardinality0..1
Terminology BindingMime Types (Required)
Typecode
Requirements

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

Summarytrue
Invariants
Affect this element
att-1Rule If the Attachment has data, it SHALL have a contentTypedata.empty() or contentType.exists()
Attachment.language
Element IdAttachment.language
Definition

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

Short DisplayHuman language of the content (BCP-47)
Cardinality0..1
Terminology BindingAll Languages (Required)
Additional BindingsPurpose
Common LanguagesStarter Set
Typecode
Requirements

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

Summarytrue
Attachment.data
Element IdAttachment.data
Definition

The actual data of the attachment - a sequence of bytes, base64 encoded.

Short DisplayData inline, base64ed
Cardinality0..1
Typebase64Binary
Requirements

The data needs to able to be transmitted inline.

Comments

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

Invariants
Affect this element
att-1Rule If the Attachment has data, it SHALL have a contentTypedata.empty() or contentType.exists()
Attachment.url
Element IdAttachment.url
Definition

A location where the data can be accessed.

Short DisplayUri where the data can be found
Cardinality0..1
Typeurl
Requirements

The data needs to be transmitted by reference.

Summarytrue
Comments

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

Attachment.size
Element IdAttachment.size
Definition

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

Short DisplayNumber of bytes of content (if url provided)
Cardinality0..1
Typeinteger64
Requirements

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

Summarytrue
Comments

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

Attachment.hash
Element IdAttachment.hash
Definition

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

Short DisplayHash of the data (sha-1, base64ed)
Cardinality0..1
Typebase64Binary
Requirements

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

Summarytrue
Comments

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

Attachment.title
Element IdAttachment.title
Definition

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

Short DisplayLabel to display in place of the data
Cardinality0..1
Typestring
Requirements

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

Summarytrue
Comments

May sometimes be derived from the source filename.

Attachment.creation
Element IdAttachment.creation
Definition

The date that the attachment was first created.

Short DisplayDate attachment was first created
Cardinality0..1
TypedateTime
Requirements

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

Summarytrue
Attachment.height
Element IdAttachment.height
Definition

Height of the image in pixels (photo/video).

Short DisplayHeight of the image in pixels (photo/video)
Cardinality0..1
TypepositiveInt
Attachment.width
Element IdAttachment.width
Definition

Width of the image in pixels (photo/video).

Short DisplayWidth of the image in pixels (photo/video)
Cardinality0..1
TypepositiveInt
Attachment.frames
Element IdAttachment.frames
Definition

The number of frames in a photo. This is used with a multi-page fax, or an imaging acquisition context that takes multiple slices in a single image, or an animated gif. If there is more than one frame, this SHALL have a value in order to alert interface software that a multi-frame capable rendering widget is required.

Short DisplayNumber of frames if > 1 (photo)
Cardinality0..1
TypepositiveInt
Comments

if the number of frames is not supplied, the value may be unknown. Applications should not assume that there is only one frame unless it is explicitly stated.

Attachment.duration
Element IdAttachment.duration
Definition

The duration of the recording in seconds - for audio and video.

Short DisplayLength in seconds (audio / video)
Cardinality0..1
Typedecimal
Comments

The duration might differ from occurrencePeriod if recording was paused.

Attachment.pages
Element IdAttachment.pages
Definition

The number of pages when printed.

Short DisplayNumber of printed pages
Cardinality0..1
TypepositiveInt
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Identifier
Standards StatusThis element has a standards status of "Normative"
Element IdIdentifier
Definition

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

Short DisplayAn identifier intended for computation
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

Invariants
Defined on this element
ident-1Warning Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reasonvalue.exists()
Identifier.use
Element IdIdentifier.use
Definition

The purpose of this identifier.

Short Displayusual | official | temp | secondary | old (If known)
Cardinality0..1
Terminology BindingIdentifierUse (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.)
Requirements

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

Summarytrue
Comments

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

Identifier.type
Element IdIdentifier.type
Definition

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

Short DisplayDescription of identifier
Cardinality0..1
Terminology BindingIdentifier Type Codes (Extensible)
TypeCodeableConcept
Requirements

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

Summarytrue
Comments

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

Identifier.system
Element IdIdentifier.system
Definition

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

Short DisplayThe namespace for the identifier value
Cardinality0..1
Typeuri
Requirements

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

Summarytrue
Comments

Identifier.system is always case sensitive.

Identifier.value
Element IdIdentifier.value
Definition

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

Short DisplayThe value that is unique
Cardinality0..1
Typestring
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Invariants
Affect this element
ident-1Warning Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reasonvalue.exists()
Identifier.period
Element IdIdentifier.period
Definition

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

Short DisplayTime period when id is/was valid for use
Cardinality0..1
TypePeriod
Summarytrue
Identifier.assigner
Element IdIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Short DisplayOrganization that issued id (may be just text)
Cardinality0..1
TypeReference(Organization)
Summarytrue
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Coding
Standards StatusThis element has a standards status of "Normative"
Element IdCoding
Definition

A reference to a code defined by a terminology system.

Short DisplayA reference to a code defined by a terminology system
Cardinality0..*
TypeDataType
Requirements

References to codes are very common in healthcare models.

Summarytrue
Comments

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

Invariants
Defined on this element
cod-1Warning A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.textcode.exists().not() implies display.exists().not()
Coding.system
Element IdCoding.system
Definition

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

Short DisplayIdentity of the terminology system
Cardinality0..1
Typeuri
Requirements

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

Summarytrue
Comments

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

Coding.version
Element IdCoding.version
Definition

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

Short DisplayVersion of the system - if relevant
NoteThis is a business versionId, not a resource version id (see discussion)
Cardinality0..1
Typestring
Summarytrue
Comments

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

Coding.code
Element IdCoding.code
Definition

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

Short DisplaySymbol in syntax defined by the system
Cardinality0..1
Typecode
Requirements

Need to refer to a particular code in the system.

Summarytrue
Invariants
Affect this element
cod-1Warning A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.textcode.exists().not() implies display.exists().not()
Coding.display
Element IdCoding.display
Definition

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

Short DisplayRepresentation defined by the system
Cardinality0..1
Typestring
Requirements

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

Summarytrue
Invariants
Affect this element
cod-1Warning A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.textcode.exists().not() implies display.exists().not()
Coding.userSelected
Element IdCoding.userSelected
Definition

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

Short DisplayIf this coding was chosen directly by the user
Cardinality0..1
Typeboolean
Requirements

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

Summarytrue
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

CodeableConcept
Standards StatusThis element has a standards status of "Normative"
Element IdCodeableConcept
Definition

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

Short DisplayConcept - reference to a terminology or just text
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

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

CodeableConcept.coding
Element IdCodeableConcept.coding
Definition

A reference to a code defined by a terminology system.

Short DisplayCode defined by a terminology system
Cardinality0..*
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Summarytrue
Comments

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

CodeableConcept.text
Element IdCodeableConcept.text
Definition

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

Short DisplayPlain text representation of the concept
Cardinality0..1
Typestring
Requirements

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

Summarytrue
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Quantity
Standards StatusThis element has a standards status of "Normative"
Element IdQuantity
Definition

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

Short DisplayA measured or measurable amount
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

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

Invariants
Defined on this element
qty-3Rule If a code for the unit is present, the system SHALL also be presentcode.empty() or system.exists()
Quantity.value
Element IdQuantity.value
Definition

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

Short DisplayNumerical value (with implicit precision)
Cardinality0..1
Typedecimal
Requirements

Precision is handled implicitly in almost all cases of measurement.

Summarytrue
Comments

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

Quantity.comparator
Element IdQuantity.comparator
Definition

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

Short Display< | <= | >= | > | ad - how to understand the value
Cardinality0..1
Terminology BindingQuantityComparator (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value)
Meaning if MissingIf there is no comparator, then there is no modification of the value
Requirements

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

Summarytrue
Quantity.unit
Element IdQuantity.unit
Definition

A human-readable form of the unit.

Short DisplayUnit representation
Cardinality0..1
Typestring
Requirements

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

Summarytrue
Quantity.system
Element IdQuantity.system
Definition

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

Short DisplaySystem that defines coded unit form
Cardinality0..1
Typeuri
Requirements

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

Summarytrue
Invariants
Affect this element
qty-3Rule If a code for the unit is present, the system SHALL also be presentcode.empty() or system.exists()
Quantity.code
Element IdQuantity.code
Definition

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

Short DisplayCoded form of the unit
Cardinality0..1
Typecode
Requirements

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

Summarytrue
Comments

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

Invariants
Affect this element
qty-3Rule If a code for the unit is present, the system SHALL also be presentcode.empty() or system.exists()
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Money
Standards StatusThis element has a standards status of "Normative"
Element IdMoney
Definition

An amount of economic utility in some recognized currency.

Short DisplayAn amount of economic utility in some recognized currency
Cardinality0..*
TypeDataType
Summarytrue
Money.value
Element IdMoney.value
Definition

Numerical value (with implicit precision).

Short DisplayNumerical value (with implicit precision)
Cardinality0..1
Typedecimal
Requirements

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

Summarytrue
Comments

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

Money.currency
Element IdMoney.currency
Definition

ISO 4217 Currency Code.

Short DisplayISO 4217 Currency Code
Cardinality0..1
Terminology BindingCurrencies (Required)
Typecode
Requirements

A code indicating the currency, taken from ISO 4217.

Summarytrue
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Range
Standards StatusThis element has a standards status of "Normative"
Element IdRange
Definition

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

Short DisplaySet of values bounded by low and high
Cardinality0..*
TypeDataType
Requirements

Need to be able to specify ranges of values.

Summarytrue
Comments

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

Invariants
Defined on this element
rng-2Rule If present, low SHALL have a lower value than highlow.value.empty() or high.value.empty() or low.lowBoundary().comparable(high.highBoundary()).not() or (low.lowBoundary() <= high.highBoundary())
Range.low
Element IdRange.low
Definition

The low limit. The boundary is inclusive.

Short DisplayLow limit
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Comments

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

Invariants
Affect this element
rng-2Rule If present, low SHALL have a lower value than highlow.value.empty() or high.value.empty() or low.lowBoundary().comparable(high.highBoundary()).not() or (low.lowBoundary() <= high.highBoundary())
Range.high
Element IdRange.high
Definition

The high limit. The boundary is inclusive.

Short DisplayHigh limit
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Comments

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

Invariants
Affect this element
rng-2Rule If present, low SHALL have a lower value than highlow.value.empty() or high.value.empty() or low.lowBoundary().comparable(high.highBoundary()).not() or (low.lowBoundary() <= high.highBoundary())
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Ratio
Standards StatusThis element has a standards status of "Normative"
Element IdRatio
Definition

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

Short DisplayA ratio of two Quantity values - a numerator and a denominator
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

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

Invariants
Defined on this element
rat-1Rule Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present(numerator.exists() and denominator.exists()) or (numerator.empty() and denominator.empty() and extension.exists())
Ratio.numerator
Element IdRatio.numerator
Definition

The value of the numerator.

Short DisplayNumerator value
Cardinality0..1
TypeQuantity
Summarytrue
Invariants
Affect this element
rat-1Rule Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present(numerator.exists() and denominator.exists()) or (numerator.empty() and denominator.empty() and extension.exists())
Ratio.denominator
Element IdRatio.denominator
Definition

The value of the denominator.

Short DisplayDenominator value
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Invariants
Affect this element
rat-1Rule Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present(numerator.exists() and denominator.exists()) or (numerator.empty() and denominator.empty() and extension.exists())
FHIR Infrastructure icon Work GroupMaturity Level: 3Standards Status: Trial Use

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

RatioRange
Standards StatusThis element has a standards status of "Trial Use"
Element IdRatioRange
Definition

A range of ratios expressed as a low and high numerator and a denominator.

Short DisplayRange of ratio values
Cardinality0..*
TypeDataType
Requirements

Need to be able to specify ranges of ratios.

Summarytrue
Comments

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

Invariants
Defined on this element
ratrng-1Rule One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists())
ratrng-2Rule If present, lowNumerator SHALL have a lower value than highNumeratorlowNumerator.hasValue().not() or highNumerator.hasValue().not() or (lowNumerator.lowBoundary() <= highNumerator.highBoundary())
RatioRange.lowNumerator
Element IdRatioRange.lowNumerator
Definition

The value of the low limit numerator.

Short DisplayLow Numerator limit
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Comments

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

Invariants
Affect this element
ratrng-1Rule One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists())
ratrng-2Rule If present, lowNumerator SHALL have a lower value than highNumeratorlowNumerator.hasValue().not() or highNumerator.hasValue().not() or (lowNumerator.lowBoundary() <= highNumerator.highBoundary())
RatioRange.highNumerator
Element IdRatioRange.highNumerator
Definition

The value of the high limit numerator.

Short DisplayHigh Numerator limit
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Comments

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

Invariants
Affect this element
ratrng-1Rule One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists())
ratrng-2Rule If present, lowNumerator SHALL have a lower value than highNumeratorlowNumerator.hasValue().not() or highNumerator.hasValue().not() or (lowNumerator.lowBoundary() <= highNumerator.highBoundary())
RatioRange.denominator
Element IdRatioRange.denominator
Definition

The value of the denominator.

Short DisplayDenominator value
Cardinality0..1
TypeSimpleQuantity
Summarytrue
Invariants
Affect this element
ratrng-1Rule One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists())
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Period
Standards StatusThis element has a standards status of "Normative"
Element IdPeriod
Definition

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

Short DisplayTime range defined by start and end date/time
Cardinality0..*
TypeDataType
Summarytrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
Defined on this element
per-1Rule If present, start SHALL have a lower or equal value than endstart.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Period.start
Element IdPeriod.start
Definition

The start of the period. The boundary is inclusive.

Short DisplayStarting time with inclusive boundary
Cardinality0..1
TypedateTime
Summarytrue
Comments

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

Invariants
Affect this element
per-1Rule If present, start SHALL have a lower or equal value than endstart.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Period.end
Element IdPeriod.end
Definition

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

Short DisplayEnd time with inclusive boundary, if not ongoing
Cardinality0..1
TypedateTime
Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
Summarytrue
Comments

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

Invariants
Affect this element
per-1Rule If present, start SHALL have a lower or equal value than endstart.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Trial Use

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

SampledData
Standards StatusThis element has a standards status of "Trial Use"
Element IdSampledData
Definition

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

Short DisplayA series of measurements taken by a device
Cardinality0..*
TypeDataType
Requirements

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

Comments

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

Invariants
Defined on this element
sdd-1Rule A SampledData SAHLL have either an interval and offsets but not bothinterval.exists().not() xor offsets.exists().not()
SampledData.origin
Element IdSampledData.origin
Definition

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

Short DisplayZero value and units
Cardinality1..1
TypeSimpleQuantity
Summarytrue
SampledData.interval
Element IdSampledData.interval
Definition

Amount of intervalUnits between samples, e.g. milliseconds for time-based sampling.

Short DisplayNumber of intervalUnits between samples
Cardinality0..1
Typedecimal
Summarytrue
Comments

This is usually a whole number.

Invariants
Affect this element
sdd-1Rule A SampledData SAHLL have either an interval and offsets but not bothinterval.exists().not() xor offsets.exists().not()
SampledData.intervalUnit
Element IdSampledData.intervalUnit
Definition

The measurement unit in which the sample interval is expressed.

Short DisplayThe measurement unit of the interval between samples
Cardinality1..1
Terminology BindingUCUM Codes (Required)
Typecode
Summarytrue
SampledData.factor
Element IdSampledData.factor
Definition

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

Short DisplayMultiply data by this before adding to origin
Cardinality0..1
Typedecimal
Meaning if MissingIf no factor is assigned, the data is not adjusted before adding to the origin
Summarytrue
SampledData.lowerLimit
Element IdSampledData.lowerLimit
Definition

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

Short DisplayLower limit of detection
Cardinality0..1
Typedecimal
Summarytrue
SampledData.upperLimit
Element IdSampledData.upperLimit
Definition

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

Short DisplayUpper limit of detection
Cardinality0..1
Typedecimal
Summarytrue
SampledData.dimensions
Element IdSampledData.dimensions
Definition

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

Short DisplayNumber of sample points at each time point
Cardinality1..1
TypepositiveInt
Summarytrue
Comments

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

SampledData.codeMap
Element IdSampledData.codeMap
Definition

Reference to ConceptMap that defines the codes used in the data.

Short DisplayDefines the codes used in the data
Cardinality0..1
Typecanonical(ConceptMap)
Comments

The ConceptMap cannot define meanings for the codes 'E', 'U', or 'L' (nor 'e', 'u', or 'l').

SampledData.offsets
Element IdSampledData.offsets
Definition

A series of data points which are decimal values separated by a single space (character u20). The units in which the offsets are expressed are found in intervalUnit. The absolute point at which the measurements begin SHALL be conveyed outside the scope of this datatype, e.g. Observation.effectiveDateTime for a timing offset.

Short DisplayOffsets, typically in time, at which data values were taken
Cardinality0..1
Typestring
Comments

If offsets is present, the number of data points must be equal to the number of offsets mlutipled by the dimensions.

Invariants
Affect this element
sdd-1Rule A SampledData SAHLL have either an interval and offsets but not bothinterval.exists().not() xor offsets.exists().not()
SampledData.data
Element IdSampledData.data
Definition

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

Short DisplayDecimal values with spaces, or "E" | "U" | "L", or another code
Cardinality0..1
Typestring
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

HumanName
Standards StatusThis element has a standards status of "Normative"
Element IdHumanName
Definition

A name, normally of a human, that can be used for other living entities (e.g. animals but not organizations) that have been assigned names by a human and may need the use of name parts or the need for usage information.

Short DisplayName of a human or other living entity - parts and usage
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

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

HumanName.use
Element IdHumanName.use
Definition

Identifies the purpose for this name.

Short Displayusual | official | temp | nickname | anonymous | old | maiden
Cardinality0..1
Terminology BindingNameUse (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one)
Requirements

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

Summarytrue
Comments

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

HumanName.text
Element IdHumanName.text
Definition

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

Short DisplayText representation of the full name
Cardinality0..1
Typestring
Requirements

A renderable, unencoded form.

Summarytrue
Comments

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

HumanName.family
Element IdHumanName.family
Definition

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

Short DisplayFamily name (often called 'Surname')
Cardinality0..1
Typestring
Alternate Namessurname
Summarytrue
Comments

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

HumanName.given
Element IdHumanName.given
Definition

Given name.

Short DisplayGiven names (not always 'first'). Includes middle names
Cardinality0..*
Typestring
Element Order MeaningGiven Names appear in the correct order for presenting the name
Alternate Namesfirst name; middle name
Summarytrue
Comments

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

HumanName.prefix
Element IdHumanName.prefix
Definition

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

Short DisplayParts that come before the name
Cardinality0..*
Typestring
Element Order MeaningPrefixes appear in the correct order for presenting the name
Summarytrue
HumanName.suffix
Element IdHumanName.suffix
Definition

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

Short DisplayParts that come after the name
Cardinality0..*
Typestring
Element Order MeaningSuffixes appear in the correct order for presenting the name
Summarytrue
HumanName.period
Element IdHumanName.period
Definition

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

Short DisplayTime period when name was/is in use
Cardinality0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

Summarytrue
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Address
Standards StatusThis element has a standards status of "Normative"
Element IdAddress
Definition

An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. The ISO21090-codedString may be used to provide a coded representation of the contents of strings in an Address.

Short DisplayAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Comments

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

Address.use
Element IdAddress.use
Definition

The purpose of this address.

Short Displayhome | work | temp | old | billing - purpose of this address
Cardinality0..1
Terminology BindingAddressUse (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one)
Requirements

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

Summarytrue
Comments

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

Address.type
Element IdAddress.type
Definition

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

Short Displaypostal | physical | both
Cardinality0..1
Terminology BindingAddressType (Required)
Typecode
Summarytrue
Comments

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

Address.text
Element IdAddress.text
Definition

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

Short DisplayText representation of the address
Cardinality0..1
Typestring
Requirements

A renderable, unencoded form.

Summarytrue
Comments

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

Address.line
Element IdAddress.line
Definition

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

Short DisplayStreet name, number, direction & P.O. Box etc.
Cardinality0..*
Typestring
Element Order MeaningThe order in which lines should appear in an address label
Summarytrue
Address.city
Element IdAddress.city
Definition

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

Short DisplayName of city, town etc.
Cardinality0..1
Typestring
Alternate NamesMunicpality
Summarytrue
Address.district
Element IdAddress.district
Definition

The name of the administrative area (county).

Short DisplayDistrict name (aka county)
Cardinality0..1
Typestring
Alternate NamesCounty
Summarytrue
Comments

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

Address.state
Element IdAddress.state
Definition

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

Short DisplaySub-unit of country (abbreviations ok)
Cardinality0..1
Typestring
Alternate NamesProvince; Territory
Summarytrue
Address.postalCode
Element IdAddress.postalCode
Definition

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

Short DisplayPostal code for area
Cardinality0..1
Typestring
Alternate NamesZip
Summarytrue
Address.country
Element IdAddress.country
Definition

Country - a nation as commonly understood or generally accepted.

Short DisplayCountry (e.g. may be ISO 3166 2 or 3 letter code)
Cardinality0..1
Typestring
Summarytrue
Comments

ISO 3166 2- or 3- letter codes MAY be used in place of a human readable country name.

Address.period
Element IdAddress.period
Definition

Time period when address was/is in use.

Short DisplayTime period when address was/is in use
Cardinality0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Summarytrue
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

ContactPoint
Standards StatusThis element has a standards status of "Normative"
Element IdContactPoint
Definition

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

Short DisplayDetails of a Technology mediated contact point (phone, fax, email, etc.)
Cardinality0..*
TypeDataType
Requirements

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

Summarytrue
Invariants
Defined on this element
cpt-2Rule A system is required if a value is provided.value.empty() or system.exists()
ContactPoint.system
Element IdContactPoint.system
Definition

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

Short Displayphone | fax | email | pager | url | sms | other
Cardinality0..1
Terminology BindingContactPointSystem (Required)
Typecode
Summarytrue
Invariants
Affect this element
cpt-2Rule A system is required if a value is provided.value.empty() or system.exists()
ContactPoint.value
Element IdContactPoint.value
Definition

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

Short DisplayThe actual contact point details
Cardinality0..1
Typestring
Requirements

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

Summarytrue
Comments

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

Invariants
Affect this element
cpt-2Rule A system is required if a value is provided.value.empty() or system.exists()
ContactPoint.use
Element IdContactPoint.use
Definition

Identifies the purpose for the contact point.

Short Displayhome | work | temp | old | mobile - purpose of this contact point
Cardinality0..1
Terminology BindingContactPointUse (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one)
Requirements

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

Summarytrue
Comments

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

ContactPoint.rank
Element IdContactPoint.rank
Definition

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

Short DisplaySpecify preferred order of use (1 = highest)
Cardinality0..1
TypepositiveInt
Summarytrue
Comments

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

Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.

Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.

ContactPoint.period
Element IdContactPoint.period
Definition

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

Short DisplayTime period when the contact point was/is in use
Cardinality0..1
TypePeriod
Summarytrue
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Timing
Standards StatusThis element has a standards status of "Normative"
Element IdTiming
Definition

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

Short DisplayA timing schedule that specifies an event that may occur multiple times
Cardinality0..*
TypeBackboneType
Requirements

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

Summarytrue
Comments

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

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

Timing.event
Element IdTiming.event
Definition

Identifies specific times when the event occurs.

Short DisplayWhen the event occurs
Cardinality0..*
TypedateTime
Requirements

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

Summarytrue
Timing.repeat
Element IdTiming.repeat
Definition

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

Short DisplayWhen the event is to occur
Cardinality0..1
Requirements

Many timing schedules are determined by regular repetitions.

Summarytrue
Invariants
Defined on this element
tim-1Rule if there's a duration, there needs to be duration unitsduration.empty() or durationUnit.exists()
tim-2Rule if there's a period, there needs to be period unitsperiod.empty() or periodUnit.exists()
tim-4Rule duration SHALL be a non-negative valueduration.exists() implies duration >= 0
tim-5Rule period SHALL be a non-negative valueperiod.exists() implies period >= 0
tim-6Rule If there's a periodMax, there must be a periodperiodMax.empty() or period.exists()
tim-7Rule If there's a durationMax, there must be a durationdurationMax.empty() or duration.exists()
tim-8Rule If there's a countMax, there must be a countcountMax.empty() or count.exists()
tim-9Rule If there's an offset, there must be a when (and not C, CM, CD, CV)offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse())
tim-10Rule If there's a timeOfDay, there cannot be a when, or vice versatimeOfDay.empty() or when.empty()
Timing.repeat.bounds[x]
Element IdTiming.repeat.bounds[x]
Definition

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

Short DisplayLength/Range of lengths, or (Start and/or end) limits
Cardinality0..1
TypeDuration|Range|Period
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summarytrue
Timing.repeat.count
Element IdTiming.repeat.count
Definition

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

Short DisplayNumber of times to repeat
Cardinality0..1
TypepositiveInt
Requirements

Repetitions may be limited by end time or total occurrences.

Summarytrue
Comments

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

Invariants
Affect this element
tim-8Rule If there's a countMax, there must be a countcountMax.empty() or count.exists()
Timing.repeat.countMax
Element IdTiming.repeat.countMax
Definition

If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

Short DisplayMaximum number of times to repeat
Cardinality0..1
TypepositiveInt
Summarytrue
Invariants
Affect this element
tim-8Rule If there's a countMax, there must be a countcountMax.empty() or count.exists()
Timing.repeat.duration
Element IdTiming.repeat.duration
Definition

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

Short DisplayHow long when it happens
Cardinality0..1
Typedecimal
Requirements

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

Summarytrue
Comments

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

Invariants
Affect this element
tim-7Rule If there's a durationMax, there must be a durationdurationMax.empty() or duration.exists()
tim-1Rule if there's a duration, there needs to be duration unitsduration.empty() or durationUnit.exists()
tim-4Rule duration SHALL be a non-negative valueduration.exists() implies duration >= 0
Timing.repeat.durationMax
Element IdTiming.repeat.durationMax
Definition

If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

Short DisplayHow long when it happens (Max)
Cardinality0..1
Typedecimal
Requirements

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

Summarytrue
Comments

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

Invariants
Affect this element
tim-7Rule If there's a durationMax, there must be a durationdurationMax.empty() or duration.exists()
Timing.repeat.durationUnit
Element IdTiming.repeat.durationUnit
Definition

The units of time for the duration, in UCUM units Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

Short Displays | min | h | d | wk | mo | a - unit of time (UCUM)
Cardinality0..1
Terminology BindingUnitsOfTime (Required)
Typecode
Summarytrue
Invariants
Affect this element
tim-1Rule if there's a duration, there needs to be duration unitsduration.empty() or durationUnit.exists()
Timing.repeat.frequency
Element IdTiming.repeat.frequency
Definition

The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

Short DisplayIndicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period
Cardinality0..1
TypepositiveInt
Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Summarytrue
Timing.repeat.frequencyMax
Element IdTiming.repeat.frequencyMax
Definition

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

Short DisplayEvent occurs up to frequencyMax times per period
Cardinality0..1
TypepositiveInt
Summarytrue
Timing.repeat.period
Element IdTiming.repeat.period
Definition

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

Short DisplayThe duration to which the frequency applies. I.e. Event occurs frequency times per period
Cardinality0..1
Typedecimal
Summarytrue
Invariants
Affect this element
tim-6Rule If there's a periodMax, there must be a periodperiodMax.empty() or period.exists()
tim-5Rule period SHALL be a non-negative valueperiod.exists() implies period >= 0
tim-2Rule if there's a period, there needs to be period unitsperiod.empty() or periodUnit.exists()
Timing.repeat.periodMax
Element IdTiming.repeat.periodMax
Definition

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

Short DisplayUpper limit of period (3-4 hours)
Cardinality0..1
Typedecimal
Summarytrue
Invariants
Affect this element
tim-6Rule If there's a periodMax, there must be a periodperiodMax.empty() or period.exists()
Timing.repeat.periodUnit
Element IdTiming.repeat.periodUnit
Definition

The units of time for the period in UCUM units Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

Short Displays | min | h | d | wk | mo | a - unit of time (UCUM)
Cardinality0..1
Terminology BindingUnitsOfTime (Required)
Typecode
Summarytrue
Invariants
Affect this element
tim-2Rule if there's a period, there needs to be period unitsperiod.empty() or periodUnit.exists()
Timing.repeat.dayOfWeek
Element IdTiming.repeat.dayOfWeek
Definition

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

Short Displaymon | tue | wed | thu | fri | sat | sun
Cardinality0..*
Terminology BindingDays Of Week (Required)
Typecode
Summarytrue
Comments

If no days are specified, the action is assumed to happen every day as otherwise specified.

Timing.repeat.timeOfDay
Element IdTiming.repeat.timeOfDay
Definition

Specified time of day for action to take place.

Short DisplayTime of day for action
Cardinality0..*
Typetime
Summarytrue
Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. If there's a timeOfDay, there cannot be a when, or vice versa.

Invariants
Affect this element
tim-10Rule If there's a timeOfDay, there cannot be a when, or vice versatimeOfDay.empty() or when.empty()
Timing.repeat.when
Element IdTiming.repeat.when
Definition

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

Short DisplayCode for time period of occurrence
Cardinality0..*
Terminology BindingEventTiming (Required)
Typecode
Requirements

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

Summarytrue
Comments

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

Invariants
Affect this element
tim-9Rule If there's an offset, there must be a when (and not C, CM, CD, CV)offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse())
tim-10Rule If there's a timeOfDay, there cannot be a when, or vice versatimeOfDay.empty() or when.empty()
Timing.repeat.offset
Element IdTiming.repeat.offset
Definition

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

Short DisplayMinutes from event (before or after)
Cardinality0..1
TypeunsignedInt
Summarytrue
Invariants
Affect this element
tim-9Rule If there's an offset, there must be a when (and not C, CM, CD, CV)offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse())
Timing.code
Element IdTiming.code
Definition

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

Short DisplayC | BID | TID | QID | AM | PM | QD | QOD | +
Cardinality0..1
Terminology BindingTimingAbbreviation (Preferred)
TypeCodeableConcept
Summarytrue
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Trial Use

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

RelativeTime
Standards StatusThis element has a standards status of "Trial Use"
Element IdRelativeTime
Definition

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.

Short DisplayA point in time or an interval of time relative to an event
Cardinality0..*
TypeBackboneType
Summarytrue
Invariants
Defined on this element
rlt-1Rule A RelativeTime can have either a contextReference or contextDefinition but not bothcontextReference.empty() or contextDefinition.empty()
rlt-2Rule If RelativeTime has a contextPath, it SHALL have either a contextReference or a contextDefinitioncontextPath.empty() or contextReference.exists() or contextDefinition.exists()
RelativeTime.contextReference
Element IdRelativeTime.contextReference
Definition

The specific event occurrence or resource context used as a base point (reference point) in time. This establishes the context in which the 'path' is evaluated.

Short DisplayThe specific event occurrence or resource context used as a base point (reference point) in time
Cardinality0..1
TypeReference(Any)
Summarytrue
Invariants
Affect this element
rlt-1Rule A RelativeTime can have either a contextReference or contextDefinition but not bothcontextReference.empty() or contextDefinition.empty()
RelativeTime.contextDefinition
Element IdRelativeTime.contextDefinition
Definition

The type of event used as a base point. Instances of this definition will establish the context for evaluating the path to determine the base time for the offset.

Short DisplayThe type of event used as a base point
Cardinality0..1
Typecanonical(ActivityDefinition | PlanDefinition | ObservationDefinition)
Summarytrue
Invariants
Affect this element
rlt-1Rule A RelativeTime can have either a contextReference or contextDefinition but not bothcontextReference.empty() or contextDefinition.empty()
RelativeTime.contextPath
Element IdRelativeTime.contextPath
Definition

Path to the element defining the point in time. Any valid FHIRPath expression.

Short DisplayPath to the element defining the point in time
Cardinality0..1
Typestring
Summarytrue
Invariants
Affect this element
rlt-2Rule If RelativeTime has a contextPath, it SHALL have either a contextReference or a contextDefinitioncontextPath.empty() or contextReference.exists() or contextDefinition.exists()
RelativeTime.contextCode
Element IdRelativeTime.contextCode
Definition

Coded representation of the event used as a base point (reference point) in time.

Short DisplayCoded representation of the event used as a base point (reference point) in time
Cardinality0..1
Terminology BindingEvidence Variable Event (Example)
TypeCodeableConcept
Summarytrue
RelativeTime.offset[x]
Element IdRelativeTime.offset[x]
Definition

An offset or offset range before (negative values) or after (positive values) the event. Range is limited to time-valued quantities (Durations).

Short DisplayAn offset or offset range before (negative values) or after (positive values) the event
Cardinality0..1
TypeDuration|Range
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summarytrue
RelativeTime.text
Element IdRelativeTime.text
Definition

Free-text (human-readable) description.

Short DisplayFree-text description
Cardinality0..1
Typestring
Summarytrue
FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Signature
Standards StatusThis element has a standards status of "Trial Use"
Element IdSignature
Definition

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

Short DisplayA Signature - XML DigSig, JWS, Graphical image of signature, etc.
Cardinality0..*
TypeDataType
Requirements

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

Comments

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

Signature.type
Element IdSignature.type
Definition

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

Short DisplayIndication of the reason the entity signed the object(s)
Cardinality0..*
Terminology BindingSignature Type Codes (Preferred)
TypeCoding
Summarytrue
Comments

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

Signature.when
Element IdSignature.when
Definition

When the digital signature was signed.

Short DisplayWhen the signature was created
Cardinality0..1
Typeinstant
Summarytrue
Comments

This should agree with the information in the signature.

Signature.who
Element IdSignature.who
Definition

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

Short DisplayWho signed
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)
Summarytrue
Comments

This should agree with the information in the signature.

Signature.onBehalfOf
Element IdSignature.onBehalfOf
Definition

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

Short DisplayThe party represented
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)
Requirements

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

Summarytrue
Comments

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

Signature.targetFormat
Element IdSignature.targetFormat
Definition

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

Short DisplayThe technical format of the signed resources
Cardinality0..1
Terminology BindingMime Types (Required)
Typecode
Comments

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

Signature.sigFormat
Element IdSignature.sigFormat
Definition

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

Short DisplayThe technical format of the signature
Cardinality0..1
Terminology BindingMime Types (Required)
Typecode
Signature.data
Element IdSignature.data
Definition

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

Short DisplayThe actual signature content (XML DigSig. JWS, picture, etc.)
Cardinality0..1
Typebase64Binary
Comments

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

FHIR Infrastructure icon Work GroupMaturity Level: 5Standards Status: Normative

See also Base Definition, Examples, Mappings, Profiles, Extensions and R4 Conversions

Annotation
Standards StatusThis element has a standards status of "Normative"
Element IdAnnotation
Definition

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

Short DisplayText node with attribution
Cardinality0..*
TypeDataType
Comments

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

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

The individual responsible for making the annotation.

Short DisplayIndividual responsible for the annotation
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)|string
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summarytrue
Comments

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

Annotation.time
Element IdAnnotation.time
Definition

Indicates when this particular annotation was made.

Short DisplayWhen the annotation was made
Cardinality0..1
TypedateTime
Summarytrue
Annotation.text
Element IdAnnotation.text
Definition

The text of the annotation in markdown format.

Short DisplayThe annotation - text content (as markdown)
Cardinality1..1
Typemarkdown
Summarytrue