Introduction

This profile is used to represent the Central Cancer Registry Report Content. The content bundle is represented using a bundle of type Document using the Composition resource.

Profiles from Other IGs used as part of the Composition within the Content Bundle.

The content is made up data elements from the following profiles from the other IGs as direct references or as base profiles.

From the mCODE IG:

• mCODE Secondary Cancer Condition Profile
• mCODE Cancer Stage Group Profile
• mCODE TNM Distant Metastases Category Profile
• mCODE TNM Primary Tumor Category Profile
• mCODE TNM Regional Nodes Category Profile
• mCODE Cancer-Related Medication Request Profile
• mCODE Cancer-Related Administration Request Profile
• mCODE Radiotherapy Course Summary Profile

From ODH IG:

Occupation Data for Health Usual Work Profile

From US Core IG:

US Core profiles

Guidance on populating the data for each section:

The following guidance is provided to the implementers to identify the data of interest which needs to be extracted and populated in the various sections.

• Patient: The Patient who is the subject of the closed encounter
• Encounter: The encounter that triggered the HDEA (i.e., closed encounter)
• Primary Cancer Condition: Condition with a category of “encounter-diagnosis” for the closed encounter with a Condition.code value that is on the reportability list.All Conditions with do not have a clinicalStatuses of inactive can be considered to determine the primary cancer condition along with a verificationStatus of confirmed.
• Secondary Cancer Condition: Condition with a category of “encounter-diagnosis” for the closed encounter with a Condition.code that is present in the Secondary Cancer Disorder Value Set.All Conditions with do not have a clinicalStatuses of inactive can be considered to determine the primary cancer condition along with a verificationStatus of Confirmed.
• Cancer Stage Group: All Observations with the Cancer Stage Group information and a status of final, amended, or corrected
• TNM Primary Tumor Category: All Observation with TNM tumor information having a status of final, amended, or corrected
• TNM Regional Nodes Category: All Observation with TNM Regional Nodes information having a status of final, amended, or corrected
• TNM Distant Metastases Category: All Observation with TNM Metastases information having a status of final, amended, or corrected
• Radiotherapy Course Summary: All Procedures with the Radiotherapy course summary information having a status of completed, not-done, stopped, entered-in-error, unknown and a category of 108290001-Radiation Oncology and/or Radiotherapy (Procedure).
• Cancer-Related Medication Request: Medications requested during the closed encounter with a status of active, completed, cancelled, entered-in-error, stopped, unknown and an intent of order.
• Cancer-Related Medication Administration: Medications administered during the closed encounter with a status of completed, in-progress, entered-in-error, stopped or unknown.
• Usual Work: Usual Work information for the patient with a status of final.
• Laboratory Resul : Results linked to the encounter or ordered during the encounter or results received during the Encounter with a status of final
• Vital Signs: All vital signs for the encounter with status of final, corrected, unknown or amended
• Procedure: Procedures performed during the closed encounter limited to status of completed or unknown.
• DiagnosticReport Profile for Laboratory Results Reporting: Results linked to the encounter or ordered during the encounter or results received during the Encounter and Status of final
• DiagnosticReport Profile for Report and Note exchange: Results linked to the encounter or ordered during the encounter or results received during the Encounter and Status of final
• DocumentReference: All notes created during the encounter with a status of current
• Smoking Status: Smoking Status associated with the patient with status of final.

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

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints
Bundle		0..*	Bundle	Contains a collection of resources
Slices for entry	S	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:composition	S	1..1	BackboneElement	Entry in the bundle - will have a resource or information
resource		0..1	CcrrComposition	Central Cancer Registry Composition Profile
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources bdl-1: total only when a search or history bdl-2: entry.search only when a search bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited 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) bdl-9: A document must have an identifier with a system and a value bdl-10: A document must have a date bdl-11: A document must have a Composition as the first resource bdl-12: A message must have a MessageHeader as the first resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	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.
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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:composition	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	0..1	CcrrComposition	Central Cancer Registry Composition Profile
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Bundle.type	required	BundleType http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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:composition	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:composition	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()

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources bdl-1: total only when a search or history bdl-2: entry.search only when a search bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited 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) bdl-9: A document must have an identifier with a system and a value bdl-10: A document must have a date bdl-11: A document must have a Composition as the first resource bdl-12: A message must have a MessageHeader as the first resource
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	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.
timestamp	Σ	0..1	instant	When the bundle was assembled
total	ΣC	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	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	ΣC	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	ΣC	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	ΣC	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:composition	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	0..1	CcrrComposition	Central Cancer Registry Composition Profile
search	ΣC	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	ΣC	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	ΣC	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	Conformance	ValueSet	URI
Bundle.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Bundle.type	required	BundleType http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 from the FHIR Standard
Bundle.entry.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 from the FHIR Standard
Bundle.entry.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 from the FHIR Standard
Bundle.entry:composition.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 from the FHIR Standard
Bundle.entry:composition.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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:composition	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:composition	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
Bundle		0..*	Bundle	Contains a collection of resources
Slices for entry	S	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:composition	S	1..1	BackboneElement	Entry in the bundle - will have a resource or information
resource		0..1	CcrrComposition	Central Cancer Registry Composition Profile
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources bdl-1: total only when a search or history bdl-2: entry.search only when a search bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited 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) bdl-9: A document must have an identifier with a system and a value bdl-10: A document must have a date bdl-11: A document must have a Composition as the first resource bdl-12: A message must have a MessageHeader as the first resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	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.
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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:composition	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	0..1	CcrrComposition	Central Cancer Registry Composition Profile
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Bundle.type	required	BundleType http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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:composition	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:composition	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources bdl-1: total only when a search or history bdl-2: entry.search only when a search bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited 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) bdl-9: A document must have an identifier with a system and a value bdl-10: A document must have a date bdl-11: A document must have a Composition as the first resource bdl-12: A message must have a MessageHeader as the first resource
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	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.
timestamp	Σ	0..1	instant	When the bundle was assembled
total	ΣC	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	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	ΣC	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	ΣC	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	ΣC	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:composition	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information bdl-5: must be a resource unless there's a request or response bdl-8: fullUrl cannot be a version specific reference 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	0..1	CcrrComposition	Central Cancer Registry Composition Profile
search	ΣC	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	ΣC	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	ΣC	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	Conformance	ValueSet	URI
Bundle.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Bundle.type	required	BundleType http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 from the FHIR Standard
Bundle.entry.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 from the FHIR Standard
Bundle.entry.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 from the FHIR Standard
Bundle.entry:composition.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 from the FHIR Standard
Bundle.entry:composition.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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:composition	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:composition	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: 2 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• Central Cancer Registry Report Composition (http://hl7.org/fhir/us/central-cancer-registry-reporting/StructureDefinition/ccrr-composition)

Slices

This structure defines the following Slices:

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