Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1

Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

## Resource Profile: Risk Adjustment Coding Gap Report Bundle

Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport-bundle | Version: 2.1.0
Standards status: Draft | Maturity Level: 1 | Computable Name: RAMeasureReportBundle
Other Identifiers: OID:2.16.840.1.113883.4.642.40.29.42.11
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The Risk Adjustment Coding Gap Report Bundle Profile describes a collection bundle returned by the $ra.evaluate-measure operation. This bundle is a collection of Risk Adjustment Coding Gap Reports.

This profile builds on Bundle.

### Mandatory Data Elements and Terminology

The following data-elements must always be present (Mandatory) or must be supported (Must Support). The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Bundle must have:

1. A `Bundle.type` with a fixed code "collection"
2. A `Bundle` contains one to many `Bundle.entry`
3. A `Bundle` contains one `Bundle.entry` that is a US Core Patient

Each Bundle should have ([Must Support]):

1. Zero to many `Bundle.entry` that contains a MeasureReport using the Risk Adjustment Coding Gap Report Profile for a particular Risk Adjustment Model

Additional Profile specific implementation guidance:

1. All risk adjustment coding gap reports contained in a Risk Adjustment Coding Gap Report Bundle SHALL be for the same patient.

Usages:

- Examples for this Profile: Bundle/ra-bundle01
- CapabilityStatements using this Profile: Risk Adjustment Reporting Client Capability Statement and Risk Adjustment Reporting Server Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
type | S Σ | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
entry:ra_measurereport_entry | S Σ C | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
entry:ra_patient_entry | S Σ C | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Bundle.type | Base | required | BundleType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
bdl-1 | error | Bundle | total only when a search or history | `total.empty() or (type = 'searchset') or (type = 'history')`
bdl-2 | error | Bundle | entry.search only when a search | `entry.search.empty() or (type = 'searchset')`
bdl-3 | error | Bundle | 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 | error | Bundle | 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-5 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | must be a resource unless there's a request or response | `resource.exists() or request.exists() or response.exists()`
bdl-7 | error | Bundle | 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-8 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | fullUrl cannot be a version specific reference | `fullUrl.contains('/_history/').not()`
bdl-9 | error | Bundle | A document must have an identifier with a system and a value | `type = 'document' implies (identifier.system.exists() and identifier.value.exists())`
bdl-10 | error | Bundle | A document must have a date | `type = 'document' implies (timestamp.hasValue())`
bdl-11 | error | Bundle | A document must have a Composition as the first resource | `type = 'document' implies entry.first().resource.is(Composition)`
bdl-12 | error | Bundle | A message must have a MessageHeader as the first resource | `type = 'message' implies entry.first().resource.is(MessageHeader)`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Bundle

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle |  | 0..* | Bundle | Contains a collection of resources
type | S | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
Slices for entry | S | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:ra_measurereport_entry | S | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient.
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
entry:ra_patient_entry | S | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries.
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
identifier | Σ | 0..1 | Identifier | Persistent identifier for the bundle
type | S Σ | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp | Σ | 0..1 | instant | When the bundle was assembled
total | Σ C | 0..1 | unsignedInt | If search, the total number of matches
link | Σ | 0..* | BackboneElement | Links related to this Bundle
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relation | Σ | 1..1 | string | See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url | Σ | 1..1 | uri | Reference details for the link
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | Σ | 0..1 | Resource | A resource in the bundle
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:ra_measurereport_entry | S Σ C | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:ra_patient_entry | S Σ C | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
signature | Σ | 0..1 | Signature | Digital Signature
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Bundle.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Bundle.type | Base | required | BundleType | 📍4.0.1 | FHIR Std.
Bundle.entry.search.​mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry.request.​method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_measurereport_entry.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_measurereport_entry.​request.method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_patient_entry.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_patient_entry.​request.method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
bdl-1 | error | Bundle | total only when a search or history | `total.empty() or (type = 'searchset') or (type = 'history')`
bdl-2 | error | Bundle | entry.search only when a search | `entry.search.empty() or (type = 'searchset')`
bdl-3 | error | Bundle | 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 | error | Bundle | 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-5 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | must be a resource unless there's a request or response | `resource.exists() or request.exists() or response.exists()`
bdl-7 | error | Bundle | 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-8 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | fullUrl cannot be a version specific reference | `fullUrl.contains('/_history/').not()`
bdl-9 | error | Bundle | A document must have an identifier with a system and a value | `type = 'document' implies (identifier.system.exists() and identifier.value.exists())`
bdl-10 | error | Bundle | A document must have a date | `type = 'document' implies (timestamp.hasValue())`
bdl-11 | error | Bundle | A document must have a Composition as the first resource | `type = 'document' implies entry.first().resource.is(Composition)`
bdl-12 | error | Bundle | A message must have a MessageHeader as the first resource | `type = 'message' implies entry.first().resource.is(MessageHeader)`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Bundle

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 6 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- Risk Adjustment Coding Gap MeasureReport (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Bundle.entry

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
type | S Σ | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
entry:ra_measurereport_entry | S Σ C | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
entry:ra_patient_entry | S Σ C | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Bundle.type | Base | required | BundleType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
bdl-1 | error | Bundle | total only when a search or history | `total.empty() or (type = 'searchset') or (type = 'history')`
bdl-2 | error | Bundle | entry.search only when a search | `entry.search.empty() or (type = 'searchset')`
bdl-3 | error | Bundle | 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 | error | Bundle | 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-5 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | must be a resource unless there's a request or response | `resource.exists() or request.exists() or response.exists()`
bdl-7 | error | Bundle | 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-8 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | fullUrl cannot be a version specific reference | `fullUrl.contains('/_history/').not()`
bdl-9 | error | Bundle | A document must have an identifier with a system and a value | `type = 'document' implies (identifier.system.exists() and identifier.value.exists())`
bdl-10 | error | Bundle | A document must have a date | `type = 'document' implies (timestamp.hasValue())`
bdl-11 | error | Bundle | A document must have a Composition as the first resource | `type = 'document' implies entry.first().resource.is(Composition)`
bdl-12 | error | Bundle | A message must have a MessageHeader as the first resource | `type = 'message' implies entry.first().resource.is(MessageHeader)`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from Bundle

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle |  | 0..* | Bundle | Contains a collection of resources
type | S | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
Slices for entry | S | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:ra_measurereport_entry | S | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient.
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
entry:ra_patient_entry | S | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries.
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
identifier | Σ | 0..1 | Identifier | Persistent identifier for the bundle
type | S Σ | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp | Σ | 0..1 | instant | When the bundle was assembled
total | Σ C | 0..1 | unsignedInt | If search, the total number of matches
link | Σ | 0..* | BackboneElement | Links related to this Bundle
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relation | Σ | 1..1 | string | See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url | Σ | 1..1 | uri | Reference details for the link
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | Σ | 0..1 | Resource | A resource in the bundle
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:ra_measurereport_entry | S Σ C | 0..* | BackboneElement | Risk Adjustment Coding Gap Reports for a patient. The reports contained in a bundle must be for the same patient. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | RiskAdjustmentCodingGapMeasureReport | A patient's Risk Adjustment Coding Gap Report for a Risk Adjustment Model.
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:ra_patient_entry | S Σ C | 1..1 | BackboneElement | This is the patient of the Risk Adjustment Coding Gap Report. If the Sever does not have Risk Adjustment Coding Gap Reports for the patient, then then patient resource is returned without the Risk Adjustment MeasureReport entries. Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
link | Σ | 0..* | See link (Bundle) | Links related to this entry
fullUrl | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | USCorePatientProfile(7.0.0) | This is the Patient resource.
search | Σ C | 0..1 | BackboneElement | Search related information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
signature | Σ | 0..1 | Signature | Digital Signature
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Bundle.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Bundle.type | Base | required | BundleType | 📍4.0.1 | FHIR Std.
Bundle.entry.search.​mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry.request.​method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_measurereport_entry.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_measurereport_entry.​request.method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_patient_entry.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:ra_patient_entry.​request.method | Base | required | HTTPVerb | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
bdl-1 | error | Bundle | total only when a search or history | `total.empty() or (type = 'searchset') or (type = 'history')`
bdl-2 | error | Bundle | entry.search only when a search | `entry.search.empty() or (type = 'searchset')`
bdl-3 | error | Bundle | 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 | error | Bundle | 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-5 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | must be a resource unless there's a request or response | `resource.exists() or request.exists() or response.exists()`
bdl-7 | error | Bundle | 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-8 | error | Bundle.entry, Bundle.entry:ra_measurereport_entry, Bundle.entry:ra_patient_entry | fullUrl cannot be a version specific reference | `fullUrl.contains('/_history/').not()`
bdl-9 | error | Bundle | A document must have an identifier with a system and a value | `type = 'document' implies (identifier.system.exists() and identifier.value.exists())`
bdl-10 | error | Bundle | A document must have a date | `type = 'document' implies (timestamp.hasValue())`
bdl-11 | error | Bundle | A document must have a Composition as the first resource | `type = 'document' implies entry.first().resource.is(Composition)`
bdl-12 | error | Bundle | A message must have a MessageHeader as the first resource | `type = 'message' implies entry.first().resource.is(MessageHeader)`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Bundle

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 6 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- Risk Adjustment Coding Gap MeasureReport (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Bundle.entry

Maturity: 1

Other representations of profile: CSV, Excel, Schematron