Patient Cost Transparency Implementation Guide
2.0.1 - STU 2

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

## Resource Profile: PCTGFEPacket - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 1

Definitions for the davinci-pct-gfe-packet resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Bundle
Definition | A container for a collection of resources.
Short | Contains a collection of resources
Control | 0..*
Is Modifier | false
Summary | false
Invariants | bdl-1: total only when a search or history (`total.empty() or (type = 'searchset') or (type = 'history')`) bdl-2: entry.search only when a search (`entry.search.empty() or (type = 'searchset')`) bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited (`entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))`) bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited (`entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))`) bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) (`(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()`) bdl-9: A document must have an identifier with a system and a value (`type = 'document' implies (identifier.system.exists() and identifier.value.exists())`) bdl-10: A document must have a date (`type = 'document' implies (timestamp.hasValue())`) bdl-11: A document must have a Composition as the first resource (`type = 'document' implies entry.first().resource.is(Composition)`) bdl-12: A message must have a MessageHeader as the first resource (`type = 'message' implies entry.first().resource.is(MessageHeader)`) pct-gfe-packet-1: SHALL have a initiating provider or initiating organization, but not both. (`Bundle.entry.resource.ofType(Practitioner).exists() or Bundle.entry.resource.ofType(Organization).exists()`) pct-gfe-packet-2: All references resources SHALL be contained within the Bundle (`Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))`) bdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history')) bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset')) bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited (entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))) bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited (entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))) bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()) bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists())) bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue())) bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition)) bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
2. Bundle.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Bundle.identifier
Definition | A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Short | Persistent identifier for the bundle
Comments | Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Bundle.type
Definition | Indicates the purpose of this bundle - how it is intended to be used.
Short | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Comments | It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.
Control | 1..1
Binding | The codes SHALL be taken from BundleType http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/bundle-type|4.0.1` ) Indicates the purpose of a bundle - how it is intended to be used.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Fixed Value | `document`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Bundle.timestamp
Definition | The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Short | When the bundle was assembled
Comments | For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.
Control | 10..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Bundle.entry
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | Entry in the bundle - will have a resource or information
Control | 20..*
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
Slicing | This element introduces a set of slices on `Bundle.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resource
12. Bundle.entry.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Bundle.entry.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Bundle.entry.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
19. Bundle.entry.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Bundle.entry.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Bundle.entry:composition
Slice Name | composition
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have a PCTGFEComposition resourceEntry in the bundle - will have a resource or information
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
30. Bundle.entry:composition.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
32. Bundle.entry:composition.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Bundle.entry:composition.resource
Definition | A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.). The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A set of resources composed into a single coherent clinical statement with clinical attestationA resource in the bundle
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 10..1
Type | Composition Resource(PCT GFE Composition)
Is Modifier | false
Summary | false
36. Bundle.entry:composition.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
39. Bundle.entry:composition.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Bundle.entry:composition.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Bundle.entry:patient
Slice Name | patient
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have the patient subject of care and may have a separate subscriberEntry in the bundle - will have a resource or information
Control | 10..2*
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
50. Bundle.entry:patient.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Bundle.entry:patient.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Bundle.entry:patient.resource
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | Information about an individual or animal receiving health care servicesA resource in the bundle
Control | 10..1
Type | Patient Resource(US Core Patient Profile)
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
56. Bundle.entry:patient.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
59. Bundle.entry:patient.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Bundle.entry:patient.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Bundle.entry:coverage
Slice Name | coverage
Definition | SHALL be present submitted to a payer in the $gfe-submit operation. An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | MAY have one Coverage. SHALL be present submitted to a payer in the $gfe-submit operation.Entry in the bundle - will have a resource or information
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
70. Bundle.entry:coverage.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Bundle.entry:coverage.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Bundle.entry:coverage.resource
Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | Insurance or medical plan or a payment agreementA resource in the bundle
Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.
Control | 10..1
Type | Coverage Resource(PCT Coverage)
Is Modifier | false
Summary | false
76. Bundle.entry:coverage.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
79. Bundle.entry:coverage.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Bundle.entry:coverage.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Bundle.entry:organization
Slice Name | organization
Definition | GFE Packet initiating provider organization and/or an associated Payer. A Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation. An initiating provider SHALL be present as an initiating provider organization (an entry in this slice) or an initiating provider practitioner (practitioner slice), but not both. An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have an initiating provider or initiating organization, but not both. May also have a payer organization. Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation.Entry in the bundle - will have a resource or information
Control | 0..2*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
90. Bundle.entry:organization.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. Bundle.entry:organization.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Bundle.entry:organization.resource
Definition | A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc. The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A grouping of people or organizations with a common purposeA resource in the bundle
Control | 10..1
Type | Organization Resource(PCT Organization)
Is Modifier | false
Must Support | false
Summary | false
96. Bundle.entry:organization.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
99. Bundle.entry:organization.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Bundle.entry:organization.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. Bundle.entry:practitioner
Slice Name | practitioner
Definition | GFE Packet initiating provider practitioner. An initiating provider SHALL be present as an initiating provider practitioner (in this slice) or an initiating provider organization (an entry in the organization slice), but not both. An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have a initiating provider or initiating organization, but not both.Entry in the bundle - will have a resource or information
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
110. Bundle.entry:practitioner.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
112. Bundle.entry:practitioner.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Bundle.entry:practitioner.resource
Definition | A person who is directly or indirectly involved in the provisioning of healthcare. The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A person with a formal responsibility in the provisioning of healthcare or related servicesA resource in the bundle
Control | 10..1
Type | Practitioner Resource(PCT Practitioner)
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Provider
116. Bundle.entry:practitioner.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
119. Bundle.entry:practitioner.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Bundle.entry:practitioner.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Bundle.entry:gfeBundle
Slice Name | gfeBundle
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | MAY include GFE contributor specific GFE bundle or information about a unfulfilled GFE request (GFE Missing Bundle)Entry in the bundle - will have a resource or information
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
130. Bundle.entry:gfeBundle.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
132. Bundle.entry:gfeBundle.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Bundle.entry:gfeBundle.resource
Definition | A container for a collection of resources. The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | Contains a collection of resourcesA resource in the bundle
Control | 10..1
Type | Bundle Resource(PCT GFE Bundle, PCT GFE Missing Bundle)
Is Modifier | false
Summary | false
136. Bundle.entry:gfeBundle.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
139. Bundle.entry:gfeBundle.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Bundle.entry:gfeBundle.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Bundle.entry:attachment
Slice Name | attachment
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | MAY have attachments as DocumentReference resource(s)Entry in the bundle - will have a resource or information
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists()) bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
150. Bundle.entry:attachment.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. Bundle.entry:attachment.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL). fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Bundle.entry:attachment.resource
Definition | The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A resource in the bundle
Control | 10..1
Type | DocumentReference Resource
Is Modifier | false
Summary | true
156. Bundle.entry:attachment.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..01 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
159. Bundle.entry:attachment.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Bundle.entry:attachment.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..01 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-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 foundhere

0. Bundle
Invariants | pct-gfe-packet-1: SHALL have a initiating provider or initiating organization, but not both. (`Bundle.entry.resource.ofType(Practitioner).exists() or Bundle.entry.resource.ofType(Organization).exists()`) pct-gfe-packet-2: All references resources SHALL be contained within the Bundle (`Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))`)
2. Bundle.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
4. Bundle.type
Fixed Value | `document`
6. Bundle.timestamp
Control | 1..?
8. Bundle.entry
Control | 2..?
Slicing | This element introduces a set of slices on `Bundle.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resource
10. Bundle.entry.fullUrl
Control | 1..?
12. Bundle.entry.search
Control | 0..0
14. Bundle.entry.request
Control | 0..0
16. Bundle.entry.response
Control | 0..0
18. Bundle.entry:composition
Slice Name | composition
Short | SHALL have a PCTGFEComposition resource
Control | 1..1
Must Support | true
20. Bundle.entry:composition.resource
Control | 1..?
Type | Composition(PCT GFE Composition)
22. Bundle.entry:patient
Slice Name | patient
Short | SHALL have the patient subject of care and may have a separate subscriber
Control | 1..2
24. Bundle.entry:patient.resource
Control | 1..?
Type | Patient(US Core Patient Profile)
26. Bundle.entry:coverage
Slice Name | coverage
Definition | SHALL be present submitted to a payer in the $gfe-submit operation.
Short | MAY have one Coverage. SHALL be present submitted to a payer in the $gfe-submit operation.
Control | 0..1
Must Support | true
28. Bundle.entry:coverage.resource
Control | 1..?
Type | Coverage(PCT Coverage)
30. Bundle.entry:organization
Slice Name | organization
Definition | GFE Packet initiating provider organization and/or an associated Payer. A Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation. An initiating provider SHALL be present as an initiating provider organization (an entry in this slice) or an initiating provider practitioner (practitioner slice), but not both.
Short | SHALL have an initiating provider or initiating organization, but not both. May also have a payer organization. Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation.
Control | 0..2
Must Support | true
32. Bundle.entry:organization.resource
Control | 1..?
Type | Organization(PCT Organization)
34. Bundle.entry:practitioner
Slice Name | practitioner
Definition | GFE Packet initiating provider practitioner. An initiating provider SHALL be present as an initiating provider practitioner (in this slice) or an initiating provider organization (an entry in the organization slice), but not both.
Short | SHALL have a initiating provider or initiating organization, but not both.
Control | 0..1
Must Support | true
36. Bundle.entry:practitioner.resource
Control | 1..?
Type | Practitioner(PCT Practitioner)
38. Bundle.entry:gfeBundle
Slice Name | gfeBundle
Short | MAY include GFE contributor specific GFE bundle or information about a unfulfilled GFE request (GFE Missing Bundle)
Control | 0..*
Must Support | true
40. Bundle.entry:gfeBundle.resource
Control | 1..?
Type | Bundle(PCT GFE Bundle, PCT GFE Missing Bundle)
42. Bundle.entry:attachment
Slice Name | attachment
Short | MAY have attachments as DocumentReference resource(s)
Control | 0..*
Must Support | true
44. Bundle.entry:attachment.resource
Control | 1..?
Type | DocumentReference

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

0. Bundle
Definition | A container for a collection of resources.
Short | Contains a collection of resources
Control | 0..*
Is Modifier | false
Summary | false
Invariants | bdl-1: total only when a search or history (`total.empty() or (type = 'searchset') or (type = 'history')`) bdl-2: entry.search only when a search (`entry.search.empty() or (type = 'searchset')`) bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited (`entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))`) bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited (`entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))`) bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) (`(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()`) bdl-9: A document must have an identifier with a system and a value (`type = 'document' implies (identifier.system.exists() and identifier.value.exists())`) bdl-10: A document must have a date (`type = 'document' implies (timestamp.hasValue())`) bdl-11: A document must have a Composition as the first resource (`type = 'document' implies entry.first().resource.is(Composition)`) bdl-12: A message must have a MessageHeader as the first resource (`type = 'message' implies entry.first().resource.is(MessageHeader)`) pct-gfe-packet-1: SHALL have a initiating provider or initiating organization, but not both. (`Bundle.entry.resource.ofType(Practitioner).exists() or Bundle.entry.resource.ofType(Organization).exists()`) pct-gfe-packet-2: All references resources SHALL be contained within the Bundle (`Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))`)
2. Bundle.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Bundle.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Bundle.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Bundle.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Bundle.identifier
Definition | A persistent identifier for the bundle that won't change as a bundle is copied from server to server.
Short | Persistent identifier for the bundle
Comments | Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Bundle.type
Definition | Indicates the purpose of this bundle - how it is intended to be used.
Short | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Comments | It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.
Control | 1..1
Binding | The codes SHALL be taken from BundleType (required to `http://hl7.org/fhir/ValueSet/bundle-type|4.0.1` ) Indicates the purpose of a bundle - how it is intended to be used.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Fixed Value | `document`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. Bundle.timestamp
Definition | The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.
Short | When the bundle was assembled
Comments | For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage: document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.
Control | 1..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. Bundle.total
Definition | If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle.
Short | If search, the total number of matches
Comments | Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.
Control | 0..1 This element is affected by the following invariants: bdl-1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. Bundle.link
Definition | A series of links that provide context to this bundle.
Short | Links related to this Bundle
Comments | Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Bundle.link.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
22. Bundle.link.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. Bundle.link.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Bundle.link.relation
Definition | A name which details the functional use for this link - see http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1.
Short | See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. Bundle.link.url
Definition | The reference details for the link.
Short | Reference details for the link
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. Bundle.entry
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | Entry in the bundle - will have a resource or information
Control | 2..*
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Bundle.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resource
32. Bundle.entry.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
34. Bundle.entry.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. Bundle.entry.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
38. Bundle.entry.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Bundle.entry.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Bundle.entry.resource
Definition | The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A resource in the bundle
Control | 0..1
Type | Resource
Is Modifier | false
Summary | true
44. Bundle.entry.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
51. Bundle.entry.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Bundle.entry.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Bundle.entry:composition
Slice Name | composition
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have a PCTGFEComposition resource
Control | 1..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Bundle.entry:composition.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
76. Bundle.entry:composition.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
78. Bundle.entry:composition.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
80. Bundle.entry:composition.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Bundle.entry:composition.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Bundle.entry:composition.resource
Definition | A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).
Short | A set of resources composed into a single coherent clinical statement with clinical attestation
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 1..1
Type | Composition(PCT GFE Composition)
Is Modifier | false
Summary | false
86. Bundle.entry:composition.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
93. Bundle.entry:composition.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Bundle.entry:composition.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Bundle.entry:patient
Slice Name | patient
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | SHALL have the patient subject of care and may have a separate subscriber
Control | 1..2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Bundle.entry:patient.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
118. Bundle.entry:patient.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. Bundle.entry:patient.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. Bundle.entry:patient.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Bundle.entry:patient.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Bundle.entry:patient.resource
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Short | Information about an individual or animal receiving health care services
Control | 1..1
Type | Patient(US Core Patient Profile)
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
128. Bundle.entry:patient.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
135. Bundle.entry:patient.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Bundle.entry:patient.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Bundle.entry:coverage
Slice Name | coverage
Definition | SHALL be present submitted to a payer in the $gfe-submit operation.
Short | MAY have one Coverage. SHALL be present submitted to a payer in the $gfe-submit operation.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Bundle.entry:coverage.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
160. Bundle.entry:coverage.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
162. Bundle.entry:coverage.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
164. Bundle.entry:coverage.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. Bundle.entry:coverage.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Bundle.entry:coverage.resource
Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
Short | Insurance or medical plan or a payment agreement
Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.
Control | 1..1
Type | Coverage(PCT Coverage)
Is Modifier | false
Summary | false
170. Bundle.entry:coverage.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
177. Bundle.entry:coverage.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Bundle.entry:coverage.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Bundle.entry:organization
Slice Name | organization
Definition | GFE Packet initiating provider organization and/or an associated Payer. A Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation. An initiating provider SHALL be present as an initiating provider organization (an entry in this slice) or an initiating provider practitioner (practitioner slice), but not both.
Short | SHALL have an initiating provider or initiating organization, but not both. May also have a payer organization. Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation.
Control | 0..2
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Bundle.entry:organization.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
202. Bundle.entry:organization.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
204. Bundle.entry:organization.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
206. Bundle.entry:organization.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Bundle.entry:organization.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. Bundle.entry:organization.resource
Definition | A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.
Short | A grouping of people or organizations with a common purpose
Control | 1..1
Type | Organization(PCT Organization)
Is Modifier | false
Must Support | false
Summary | false
212. Bundle.entry:organization.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
219. Bundle.entry:organization.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Bundle.entry:organization.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Bundle.entry:practitioner
Slice Name | practitioner
Definition | GFE Packet initiating provider practitioner. An initiating provider SHALL be present as an initiating provider practitioner (in this slice) or an initiating provider organization (an entry in the organization slice), but not both.
Short | SHALL have a initiating provider or initiating organization, but not both.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. Bundle.entry:practitioner.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
244. Bundle.entry:practitioner.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
246. Bundle.entry:practitioner.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
248. Bundle.entry:practitioner.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. Bundle.entry:practitioner.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. Bundle.entry:practitioner.resource
Definition | A person who is directly or indirectly involved in the provisioning of healthcare.
Short | A person with a formal responsibility in the provisioning of healthcare or related services
Control | 1..1
Type | Practitioner(PCT Practitioner)
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Provider
254. Bundle.entry:practitioner.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
261. Bundle.entry:practitioner.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
272. Bundle.entry:practitioner.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Bundle.entry:gfeBundle
Slice Name | gfeBundle
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | MAY include GFE contributor specific GFE bundle or information about a unfulfilled GFE request (GFE Missing Bundle)
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Bundle.entry:gfeBundle.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
286. Bundle.entry:gfeBundle.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
288. Bundle.entry:gfeBundle.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
290. Bundle.entry:gfeBundle.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
292. Bundle.entry:gfeBundle.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
294. Bundle.entry:gfeBundle.resource
Definition | A container for a collection of resources.
Short | Contains a collection of resources
Control | 1..1
Type | Bundle(PCT GFE Bundle, PCT GFE Missing Bundle)
Is Modifier | false
Summary | false
296. Bundle.entry:gfeBundle.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
303. Bundle.entry:gfeBundle.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Bundle.entry:gfeBundle.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Bundle.entry:attachment
Slice Name | attachment
Definition | An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Short | MAY have attachments as DocumentReference resource(s)
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Invariants | bdl-5: must be a resource unless there's a request or response (`resource.exists() or request.exists() or response.exists()`) bdl-8: fullUrl cannot be a version specific reference (`fullUrl.contains('/_history/').not()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Bundle.entry:attachment.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
328. Bundle.entry:attachment.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
330. Bundle.entry:attachment.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
332. Bundle.entry:attachment.link
Definition | A series of links that provide context to this entry.
Short | Links related to this entry
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Bundle.entry:attachment.fullUrl
Definition | The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle) Results from operations might involve resources that are not identified.
Short | URI for resource (Absolute URL server address or URI for UUID/OID)
Comments | fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Bundle.entry:attachment.resource
Definition | The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.
Short | A resource in the bundle
Control | 1..1
Type | DocumentReference
Is Modifier | false
Summary | true
338. Bundle.entry:attachment.search
Definition | Information about the search process that lead to the creation of this entry.
Short | Search related information
Control | 0..0 This element is affected by the following invariants: bdl-2
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
345. Bundle.entry:attachment.request
Definition | Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
Short | Additional execution information (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-3
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Bundle.entry:attachment.response
Definition | Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
Short | Results of execution (transaction/batch/history)
Control | 0..0 This element is affected by the following invariants: bdl-4
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
366. Bundle.signature
Definition | Digital Signature - base64 encoded. XML-DSig or a JWT.
Short | Digital Signature
Comments | The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.
Control | 0..1
Type | Signature
Is Modifier | false
Summary | true
Requirements | A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)