Clinical Order Workflows
1.0.0-ballot - STU 1 Ballot
Clinical Order Workflows
1.0.0-ballot - STU 1 Ballot
Clinical Order Workflows, published by HL7 International / Orders and Observations. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cow-ig/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/uv/cow/StructureDefinition/cow-message-header | Version: 1.0.0-ballot | |||
| Standards status: Trial-use | Maturity Level: 1 | Computable Name: COWMessageHeader | ||
Minimum expectations for a MessageHeader resource when used for Clinical Order Workflow. This profile is used to describe the use of FHIR Messaging when RESTful-based exchange is not possible between the Placer and the Fulfiller. The purpose of the constraints for the MessageHeader resource is to make sure that the rest of the CLinical Workflow requirements that may be relevant to a particular implementation or national/regional implementation guides are compatible with the RESTful-based exchange patterns.
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:   |
|---|---|---|---|---|
  MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
  Slices for event[x] |
Σ | 1..1 | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. | |
   eventCoding |
Coding | |||
| eventUri |
uri | |||
  event[x]:eventCoding |
Σ | 0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) |
| source |
Σ | 1..1 | BackboneElement | Message source application |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
 endpoint |
Σ | 1..1 | url | Actual message source address or id |
 focus |
SΣ | 1..1 | Reference(Coordination Task) | The actual content of the message |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MessageHeader.event[x] | example | MessageEventhttp://hl7.org/fhir/ValueSet/message-eventsFrom the FHIR Standard | |
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() | |
| 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 MessageHeader
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |
| Slices for event[x] |
1..1 | Coding, uri | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this | |
| event[x]:eventCoding |
0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) | |
| focus |
S | 1..1 | Reference(Coordination Task) | The actual content of the message |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |||||
| 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.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for event[x] |
Σ | 1..1 | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. | |||||
| eventCoding |
Coding | |||||||
| eventUri |
uri | |||||||
| event[x]:eventCoding |
Σ | 0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) | ||||
| destination |
Σ | 0..* | BackboneElement | Message destination application(s) | ||||
| 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 | ||||
| name |
Σ | 0..1 | string | Name of system | ||||
| target |
Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination | ||||
| endpoint |
Σ | 1..1 | url | Actual destination address or id | ||||
| receiver |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data | ||||
| sender |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message | ||||
| enterer |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry | ||||
| author |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision | ||||
| source |
Σ | 1..1 | BackboneElement | Message source application | ||||
| 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 | ||||
| name |
Σ | 0..1 | string | Name of system | ||||
| software |
Σ | 0..1 | string | Name of software running the system | ||||
| version |
Σ | 0..1 | string | Version of software running | ||||
| contact |
Σ | 0..1 | ContactPoint | Human contact for problems | ||||
| endpoint |
Σ | 1..1 | url | Actual message source address or id | ||||
| responsible |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event | ||||
| reason |
Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence. | ||||
| response |
Σ | 0..1 | BackboneElement | If this is a reply to prior message | ||||
| 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 | ||||
| identifier |
Σ | 1..1 | id | Id of original message | ||||
| code |
Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message. | ||||
| details |
Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors | ||||
| focus |
SΣ | 1..1 | Reference(Coordination Task) | The actual content of the message | ||||
| definition |
Σ | 0..1 | canonical(MessageDefinition) | Link to the definition for this message | ||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MessageHeader.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard
| ||||
| MessageHeader.event[x] | example | MessageEventhttp://hl7.org/fhir/ValueSet/message-eventsFrom the FHIR Standard | ||||
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG | ||||
| MessageHeader.reason | example | ExampleMessageReasonCodeshttp://hl7.org/fhir/ValueSet/message-reason-encounterFrom the FHIR Standard | ||||
| MessageHeader.response.code | required | ResponseTypehttp://hl7.org/fhir/ValueSet/response-code|4.0.1From the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() | |
| 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 MessageHeader
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| Slices for event[x] |
Σ | 1..1 | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. | |
| eventCoding |
Coding | |||
| eventUri |
uri | |||
| event[x]:eventCoding |
Σ | 0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) |
| source |
Σ | 1..1 | BackboneElement | Message source application |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| endpoint |
Σ | 1..1 | url | Actual message source address or id |
| focus |
SΣ | 1..1 | Reference(Coordination Task) | The actual content of the message |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MessageHeader.event[x] | example | MessageEventhttp://hl7.org/fhir/ValueSet/message-eventsFrom the FHIR Standard | |
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() | |
| 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 MessageHeader
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |
| Slices for event[x] |
1..1 | Coding, uri | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this | |
| event[x]:eventCoding |
0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) | |
| focus |
S | 1..1 | Reference(Coordination Task) | The actual content of the message |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| MessageHeader |
0..* | MessageHeader | A resource that describes a message that is exchanged between systems | |||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for event[x] |
Σ | 1..1 | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. | |||||
| eventCoding |
Coding | |||||||
| eventUri |
uri | |||||||
| event[x]:eventCoding |
Σ | 0..1 | Coding | Code for the event this message represents or link to event definition Binding: Clinical Orders Workflow - Message Header Event Codes (extensible) | ||||
| destination |
Σ | 0..* | BackboneElement | Message destination application(s) | ||||
| 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 | ||||
| name |
Σ | 0..1 | string | Name of system | ||||
| target |
Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination | ||||
| endpoint |
Σ | 1..1 | url | Actual destination address or id | ||||
| receiver |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data | ||||
| sender |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message | ||||
| enterer |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry | ||||
| author |
Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision | ||||
| source |
Σ | 1..1 | BackboneElement | Message source application | ||||
| 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 | ||||
| name |
Σ | 0..1 | string | Name of system | ||||
| software |
Σ | 0..1 | string | Name of software running the system | ||||
| version |
Σ | 0..1 | string | Version of software running | ||||
| contact |
Σ | 0..1 | ContactPoint | Human contact for problems | ||||
| endpoint |
Σ | 1..1 | url | Actual message source address or id | ||||
| responsible |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event | ||||
| reason |
Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence. | ||||
| response |
Σ | 0..1 | BackboneElement | If this is a reply to prior message | ||||
| 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 | ||||
| identifier |
Σ | 1..1 | id | Id of original message | ||||
| code |
Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message. | ||||
| details |
Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors | ||||
| focus |
SΣ | 1..1 | Reference(Coordination Task) | The actual content of the message | ||||
| definition |
Σ | 0..1 | canonical(MessageDefinition) | Link to the definition for this message | ||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MessageHeader.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard
| ||||
| MessageHeader.event[x] | example | MessageEventhttp://hl7.org/fhir/ValueSet/message-eventsFrom the FHIR Standard | ||||
| MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodeshttp://hl7.org/fhir/uv/cow/ValueSet/message-header-eventFrom this IG | ||||
| MessageHeader.reason | example | ExampleMessageReasonCodeshttp://hl7.org/fhir/ValueSet/message-reason-encounterFrom the FHIR Standard | ||||
| MessageHeader.response.code | required | ResponseTypehttp://hl7.org/fhir/ValueSet/response-code|4.0.1From the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() | |
| 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 MessageHeader
Other representations of profile: CSV, Excel, Schematron
IG © 2023+ HL7 International / Orders and Observations. Package hl7.fhir.uv.cow#1.0.0-ballot based on FHIR 4.0.1. Generated 2025-09-05
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