Bulk Data Access IG
2.0.0 - ci-build International flag

Bulk Data Access IG, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/bulk-data/ and changes regularly. See the Directory of published versions

Resource Profile: BulkCohortGroup - Detailed Descriptions

Draft as of 2024-09-30

Definitions for the bulk-cohort-group resource profile.

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

0. Group
2. Group.extension
Definition

If a groups membership is calculated periodically from the memberFilter criteria, a server SHALL populate a valueDateTime with the date the group's membership was last updated. When a date element is populated for the Group, the valueDateTime element SHALL NOT be later than the date in that element, but may be the same datetime or an earlier datetime. If members are calculated dynamically for the group (for example, when a Bulk Export operation is kicked off) this value SHALL be omitted. The server's refresh cycle capabilities and relevent configuration options SHOULD be described in the server's documentation.

Shortwhen membership in this group was updated
SlicingThis element introduces a set of slices on Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Group.extension:membersRefreshed
    Slice NamemembersRefreshed
    Control0..1
    TypeExtension(Members Refreshed) (Extension Type: dateTime)
    6. Group.modifierExtension
    Definition

    A server SHALL support the inclusion of one or more memberFilter modifier extensions containing a valueExpression with a language of application/x-fhir-query and an expression populated with a FHIR REST API query for a resource type included in the Patient or Practitioner compartment. If multiple memberFilter extensions are provided that contain criteria for different resource types, servers SHALL filter the group to only include Patients or Practitioners that have resources in their compartments that meet the conditions in all of the expressions. If multiple memberFilter extensions are provided that contain criteria for a single resource type, the server SHALL include Patients or Practitioners who have resources in their compartments that meet the criteria for that resource type in any of those expressions (a logical "or"). A server MAY also support other expression languages such as text/cql. When more than one lanugage is supported by a server a client SHALL use a single language type for all of the memberFilter expressions included in a single Group.

    FHIR search result parameters (such as _sort, _include, and _elements) SHALL NOT be used as memberFilter criteria. Clients should consult the server's capability statement to identify supported search parameters. Servers SHALL reject Group creation requests that include unsupported search parameters in a memberFilter expression. Implementation guides that reference the Bulk Cohort API, should specify required search parameters must be supported for their use case. Other implementations guides that incorporate the Bulk Export operation MAY provide a set of core search parameters that servers implementing the guide need to support.

    ShortFilter for members of this group
    Control1..?
    SlicingThis element introduces a set of slices on Group.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 8. Group.modifierExtension:memberFilter
      Slice NamememberFilter
      Control1..*
      TypeExtension(Member Filter) (Extension Type: Expression)
      10. Group.type
      Definition

      A client SHALL populate this element with person when creating a group of Patients, or practitioner when creating a group of Practitioners.

      BindingThe codes SHALL be taken from Person and Practitioner from GroupType Value Set
      (required to http://hl7.org/fhir/uv/bulkdata/ValueSet/group-type-subset)
      12. Group.actual
      ShortGroup members are described by memberFilter extension
      Pattern Valuefalse
      14. Group.name
      Control1..?
      16. Group.characteristic
      ShortThis element is not used for in groups complying with this profile
      Control0..0
      18. Group.member
      Definition

      A server MAY support the inclusion of one or more member elements that contain an entity element with a reference to a Patient resource, Practitioner resource, or Group resource that is a group of Patient resources or Practitioner resources. When members are provided, the expression in the memberFilter extension for the Group SHALL only be applied to the compartments of the referenced resources, or those of the members of referenced Group resources. When members are not provided and the Group's type element is set to person, the expression in the memberFilter extension SHALL be applied to all of the Patient compartments the client is authorized to access. When members are not provided and the Group's type element is set to practitioner, the expression in the memberFilter extension SHALL be applied to all of the Practitioner compartments the client is authorized to access.

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

      0. Group
      Definition

      Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.

      ShortGroup of multiple entities
      Comments

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

      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-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 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())
      grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
      grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
      2. Group.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.

      ShortA set of rules under which this content was created
      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.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Group.extension
      Definition

      If a groups membership is calculated periodically from the memberFilter criteria, a server SHALL populate a valueDateTime with the date the group's membership was last updated. When a date element is populated for the Group, the valueDateTime element SHALL NOT be later than the date in that element, but may be the same datetime or an earlier datetime. If members are calculated dynamically for the group (for example, when a Bulk Export operation is kicked off) this value SHALL be omitted. The server's refresh cycle capabilities and relevent configuration options SHOULD be described in the server's documentation.


      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.

      Shortwhen membership in this group was updatedAdditional content defined by implementations
      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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 Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Group.extension:membersRefreshed
        Slice NamemembersRefreshed
        Definition

        Extension used by a server to indicate to a client when the members in a dynamic group were last updated

        ShortMembers Refreshed
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Members Refreshed) (Extension Type: dateTime)
        Is Modifierfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Group.modifierExtension
        Definition

        A server SHALL support the inclusion of one or more memberFilter modifier extensions containing a valueExpression with a language of application/x-fhir-query and an expression populated with a FHIR REST API query for a resource type included in the Patient or Practitioner compartment. If multiple memberFilter extensions are provided that contain criteria for different resource types, servers SHALL filter the group to only include Patients or Practitioners that have resources in their compartments that meet the conditions in all of the expressions. If multiple memberFilter extensions are provided that contain criteria for a single resource type, the server SHALL include Patients or Practitioners who have resources in their compartments that meet the criteria for that resource type in any of those expressions (a logical "or"). A server MAY also support other expression languages such as text/cql. When more than one lanugage is supported by a server a client SHALL use a single language type for all of the memberFilter expressions included in a single Group.

        FHIR search result parameters (such as _sort, _include, and _elements) SHALL NOT be used as memberFilter criteria. Clients should consult the server's capability statement to identify supported search parameters. Servers SHALL reject Group creation requests that include unsupported search parameters in a memberFilter expression. Implementation guides that reference the Bulk Cohort API, should specify required search parameters must be supported for their use case. Other implementations guides that incorporate the Bulk Export operation MAY provide a set of core search parameters that servers implementing the guide need to support.


        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).

        ShortFilter for members of this groupExtensions that cannot be ignored
        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.

        Control10..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        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
        Invariantsele-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 Group.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 10. Group.modifierExtension:memberFilter
          Slice NamememberFilter
          Definition

          Extension to define the population of the group using FHIR REST API parameters

          ShortMember Filter
          Control1..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Member Filter) (Extension Type: Expression)
          Is Modifiertrue because Filters members of group to a subset
          Invariantsele-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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          12. Group.type
          Definition

          A client SHALL populate this element with person when creating a group of Patients, or practitioner when creating a group of Practitioners.


          Identifies the broad classification of the kind of resources the group includes.

          Shortperson | animal | practitioner | device | medication | substance
          Comments

          Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).

          Control1..1
          BindingThe codes SHALL be taken from Person and Practitioner from GroupType Value Sethttp://hl7.org/fhir/ValueSet/group-type|4.0.1
          (required to http://hl7.org/fhir/uv/bulkdata/ValueSet/group-type-subset)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Identifies what type of resources the group is made up of.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Group.actual
          Definition

          If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.

          ShortGroup members are described by memberFilter extensionDescriptive or actual
          Control1..1
          This element is affected by the following invariants: grp-1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.

          Pattern Valuefalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Group.name
          Definition

          A label assigned to the group for human identification and communication.

          ShortLabel for Group
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Used to identify the group in human communication.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Group.characteristic
          Definition

          Identifies traits whose presence r absence is shared by members of the group.

          ShortThis element is not used for in groups complying with this profileInclude / Exclude group members by Trait
          Comments

          All the identified characteristics must be true for an entity to a member of the group.

          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Needs to be a generic mechanism for identifying what individuals can be part of a group.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Group.member
          Definition

          A server MAY support the inclusion of one or more member elements that contain an entity element with a reference to a Patient resource, Practitioner resource, or Group resource that is a group of Patient resources or Practitioner resources. When members are provided, the expression in the memberFilter extension for the Group SHALL only be applied to the compartments of the referenced resources, or those of the members of referenced Group resources. When members are not provided and the Group's type element is set to person, the expression in the memberFilter extension SHALL be applied to all of the Patient compartments the client is authorized to access. When members are not provided and the Group's type element is set to practitioner, the expression in the memberFilter extension SHALL be applied to all of the Practitioner compartments the client is authorized to access.


          Identifies the resource instances that are members of the group.

          ShortWho or what is in group
          Control0..*
          This element is affected by the following invariants: grp-1
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Often the only thing of interest about a group is "who's in it".

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Group.member.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).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          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
          Invariantsele-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())
          28. Group.member.entity
          Definition

          A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.

          ShortReference to the group member
          Control1..1
          TypeReference(Patient, Practitioner, PractitionerRole, Device, Medication, Substance, Group)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

          0. Group
          Definition

          Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.

          ShortGroup of multiple entities
          Comments

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

          Control0..*
          Is Modifierfalse
          Summaryfalse
          Invariantsdom-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 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())
          grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
          2. Group.id
          Definition

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

          ShortLogical id of this artifact
          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.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. Group.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.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Group.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.

          ShortA set of rules under which this content was created
          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.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Group.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          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).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Group.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.

          ShortText summary of the resource, for human interpretation
          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.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Group.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.

          ShortContained, inline 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.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Group.extension
          Definition

          If a groups membership is calculated periodically from the memberFilter criteria, a server SHALL populate a valueDateTime with the date the group's membership was last updated. When a date element is populated for the Group, the valueDateTime element SHALL NOT be later than the date in that element, but may be the same datetime or an earlier datetime. If members are calculated dynamically for the group (for example, when a Bulk Export operation is kicked off) this value SHALL be omitted. The server's refresh cycle capabilities and relevent configuration options SHOULD be described in the server's documentation.

          Shortwhen membership in this group was updated
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-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 Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Group.extension:membersRefreshed
            Slice NamemembersRefreshed
            Definition

            Extension used by a server to indicate to a client when the members in a dynamic group were last updated

            ShortMembers Refreshed
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Members Refreshed) (Extension Type: dateTime)
            Is Modifierfalse
            Invariantsele-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())
            18. Group.modifierExtension
            Definition

            A server SHALL support the inclusion of one or more memberFilter modifier extensions containing a valueExpression with a language of application/x-fhir-query and an expression populated with a FHIR REST API query for a resource type included in the Patient or Practitioner compartment. If multiple memberFilter extensions are provided that contain criteria for different resource types, servers SHALL filter the group to only include Patients or Practitioners that have resources in their compartments that meet the conditions in all of the expressions. If multiple memberFilter extensions are provided that contain criteria for a single resource type, the server SHALL include Patients or Practitioners who have resources in their compartments that meet the criteria for that resource type in any of those expressions (a logical "or"). A server MAY also support other expression languages such as text/cql. When more than one lanugage is supported by a server a client SHALL use a single language type for all of the memberFilter expressions included in a single Group.

            FHIR search result parameters (such as _sort, _include, and _elements) SHALL NOT be used as memberFilter criteria. Clients should consult the server's capability statement to identify supported search parameters. Servers SHALL reject Group creation requests that include unsupported search parameters in a memberFilter expression. Implementation guides that reference the Bulk Cohort API, should specify required search parameters must be supported for their use case. Other implementations guides that incorporate the Bulk Export operation MAY provide a set of core search parameters that servers implementing the guide need to support.

            ShortFilter for members of this group
            Control1..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Invariantsele-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 Group.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 20. Group.modifierExtension:memberFilter
              Slice NamememberFilter
              Definition

              Extension to define the population of the group using FHIR REST API parameters

              ShortMember Filter
              Control1..*
              This element is affected by the following invariants: ele-1
              TypeExtension(Member Filter) (Extension Type: Expression)
              Is Modifiertrue because Filters members of group to a subset
              Invariantsele-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())
              22. Group.identifier
              Definition

              A unique business identifier for this group.

              ShortUnique id
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows the group to be referenced from external specifications.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. Group.active
              Definition

              Indicates whether the record for the group is available for use or is merely being retained for historical purposes.

              ShortWhether this group's record is in active use
              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).

              Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. Group.type
              Definition

              A client SHALL populate this element with person when creating a group of Patients, or practitioner when creating a group of Practitioners.

              Shortperson | animal | practitioner | device | medication | substance
              Comments

              Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).

              Control1..1
              BindingThe codes SHALL be taken from Person and Practitioner from GroupType Value Set
              (required to http://hl7.org/fhir/uv/bulkdata/ValueSet/group-type-subset)
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Identifies what type of resources the group is made up of.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. Group.actual
              Definition

              If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.

              ShortGroup members are described by memberFilter extension
              Control1..1
              This element is affected by the following invariants: grp-1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.

              Pattern Valuefalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. Group.code
              Definition

              Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.

              ShortKind of Group members
              Comments

              This would generally be omitted for Person resources.

              Control0..1
              Binding

              Kind of particular resource; e.g. cow, syringe, lake, etc.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. Group.name
              Definition

              A label assigned to the group for human identification and communication.

              ShortLabel for Group
              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Used to identify the group in human communication.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. Group.quantity
              Definition

              A count of the number of resource instances that are part of the group.

              ShortNumber of members
              Comments

              Note that the quantity may be less than the number of members if some of the members are not active.

              Control0..1
              TypeunsignedInt
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Group size is a common defining characteristic.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Group.managingEntity
              Definition

              Entity responsible for defining and maintaining Group characteristics and/or registered members.

              ShortEntity that is the custodian of the Group's definition
              Comments

              This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.

              Control0..1
              TypeReference(Organization, RelatedPerson, Practitioner, PractitionerRole)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. Group.characteristic
              Definition

              Identifies traits whose presence r absence is shared by members of the group.

              ShortThis element is not used for in groups complying with this profile
              Comments

              All the identified characteristics must be true for an entity to a member of the group.

              Control0..0
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              Needs to be a generic mechanism for identifying what individuals can be part of a group.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              47. Group.member
              Definition

              A server MAY support the inclusion of one or more member elements that contain an entity element with a reference to a Patient resource, Practitioner resource, or Group resource that is a group of Patient resources or Practitioner resources. When members are provided, the expression in the memberFilter extension for the Group SHALL only be applied to the compartments of the referenced resources, or those of the members of referenced Group resources. When members are not provided and the Group's type element is set to person, the expression in the memberFilter extension SHALL be applied to all of the Patient compartments the client is authorized to access. When members are not provided and the Group's type element is set to practitioner, the expression in the memberFilter extension SHALL be applied to all of the Practitioner compartments the client is authorized to access.

              ShortWho or what is in group
              Control0..*
              This element is affected by the following invariants: grp-1
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              Often the only thing of interest about a group is "who's in it".

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              49. Group.member.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              51. Group.member.extension
              Definition

              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.

              ShortAdditional content defined by implementations
              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-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())
              53. Group.member.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).

              ShortExtensions that cannot be ignored even if unrecognized
              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              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
              Invariantsele-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())
              55. Group.member.entity
              Definition

              A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.

              ShortReference to the group member
              Control1..1
              TypeReference(Patient, Practitioner, PractitionerRole, Device, Medication, Substance, Group)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              57. Group.member.period
              Definition

              The period that the member was in the group, if known.

              ShortPeriod member belonged to the group
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to track who was in a group at a particular time.

              Meaning if MissingThe member is in the group at this time
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              59. Group.member.inactive
              Definition

              A flag to indicate that the member is no longer in the group, but previously may have been a member.

              ShortIf member is no longer in group
              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Sometimes you don't know when someone stopped being in a group, but not when.

              Meaning if MissingMembers are considered active unless explicitly specified otherwise
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))