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

## Resource Profile: COW Message Header

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:

- Examples for this Profile: MessageHeader/cow-message-header-example

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
--- | --- | --- | --- | ---
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 | S Σ | 1..1 | Reference(Coordination Task) | The actual content of the message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events|4.0.1` From the FHIR Standard
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG

#### Constraints

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: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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.
Additional Bindings | Purpose
AllLanguages | Max Binding
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 | S Σ | 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

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages|4.0.1` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events|4.0.1` From the FHIR Standard
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG
MessageHeader.reason | example | ExampleMessageReasonCodes `http://hl7.org/fhir/ValueSet/message-reason-encounter|4.0.1` From the FHIR Standard
MessageHeader.response.code | required | ResponseType `http://hl7.org/fhir/ValueSet/response-code|4.0.1` From the FHIR Standard

#### Constraints

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

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Coordination Task (http://hl7.org/fhir/uv/cow/StructureDefinition/coordination-task)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 | S Σ | 1..1 | Reference(Coordination Task) | The actual content of the message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events|4.0.1` From the FHIR Standard
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG

#### Constraints

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: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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.
Additional Bindings | Purpose
AllLanguages | Max Binding
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 | S Σ | 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

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages|4.0.1` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events|4.0.1` From the FHIR Standard
MessageHeader.event[x]:eventCoding | extensible | MessageHeaderEventCodes `http://hl7.org/fhir/uv/cow/ValueSet/message-header-event` From this IG
MessageHeader.reason | example | ExampleMessageReasonCodes `http://hl7.org/fhir/ValueSet/message-reason-encounter|4.0.1` From the FHIR Standard
MessageHeader.response.code | required | ResponseType `http://hl7.org/fhir/ValueSet/response-code|4.0.1` From the FHIR Standard

#### Constraints

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

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Coordination Task (http://hl7.org/fhir/uv/cow/StructureDefinition/coordination-task)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron