minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0 - STU4 United States of America flag

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Resource Profile: mCODE Patient Bundle Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-patient-bundle Version: 4.0.0
Active as of 2025-02-16 Maturity Level: 1 Computable Name: MCODEPatientBundle
Other Identifiers: OID:2.16.840.1.113883.4.642.40.15.42.38

A collection of data for an mCODE cancer patient.

Usage

The bundle SHALL contain exactly one Patient resource conforming to the CancerPatient profile (any patient conforming with US Core Patient is also conformant). The bundle SHALL also contain following mCODE-conformant resources, if available to the server:

In addition, the bundle SHOULD contain the following non-mCODE resources, following appropriate US Core profiles:

  • US Core Observation resources representing vital signs, e.g., patient height, weight, blood pressure
  • Laboratory results from Comprehensive Metabolic Panels (CMP) and Complete Blood Counts (CBC)
  • Relevant resources from the Genomic Reporting IG that interpret genomic findings in terms of implications or medication recommendations, including but not limited to DiagnosticImplication resources representing evidence for or against a particular disease, condition, or cancer diagnosis.
  • Additional resources relevant to the patient but not part of mCODE, such as smoking status, family member history, and diagnostic procedures.
  • Any other resources deemed relevant to care of the cancer patient

By default, this Bundle includes all required resources described above, irrespective of care dates associated with the resources. For some types of resources, such as vital signs, a very large number of resources will therefore be included by default. To limit the number of included resources, callers MAY specify start and end parameters when requesting a patient's mCODE bundle via the Sender's FHIR API, which operate in the same way as for the Fetch Patient Record operation.

Conformance

The bundle itself SHALL validate against the current profile.

Usage:

Changes since version true:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. 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
    ele-1: All FHIR elements must have a @value or children
    ... 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.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: collection
    ... timestamp SΣ 0..1 instant When the bundle was assembled
    ele-1: All FHIR elements must have a @value or children
    .... entry:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource SΣ 1..1 Resource A resource in the bundle
    .... entry:cancerPatient SΣC 1..1 BackboneElement Cancer Patient
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource S 0..1 CancerPatient Information about an individual or animal receiving health care services
    .... entry:mcodeObservations SΣC 0..* BackboneElement FHIR Observation Resources, if they exist for the patient, including but not limited to: CancerDiseaseStatus, CancerStage (TNM and non-TNM), Comorbidities, ECOGPerformanceStatus, GenomicRegionStudied, GenomicVariant, KarnofskyPerformanceStatus, TumorMarkerTest, TumorSize, and USCoreVitalSigns.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 Observation A resource in the bundle
    .... entry:mcodeConditions SΣC 0..* BackboneElement FHIR Condition Resources, if they exist for the patient, including but not limited to: PrimaryCancerCondition, SecondaryCancerCondition, and HistoryOfMetastaticCancer.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 Condition A resource in the bundle
    .... entry:mcodeMedicationAdministrations SΣC 0..* BackboneElement FHIR Medication Administration Resources, if they exist for the patient, including but not limited to: CancerRelatedMedicationAdministration.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 MedicationAdministration A resource in the bundle
    .... entry:mcodeMedicationRequests SΣC 0..* BackboneElement FHIR Medication Request Resources, if they exist for the patient, including but not limited to: CancerRelatedMedicationRequest.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 MedicationRequest A resource in the bundle
    .... entry:mcodeDiagnosticReports SΣC 0..* BackboneElement FHIR Diagnostic Report Resources, if they exist for the patient, including but not limited to: GenomicsReport.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 DiagnosticReport A resource in the bundle
    .... entry:mcodeSpecimens SΣC 0..* BackboneElement FHIR Specimen Resources, if they exist for the patient, including but not limited to: HumanSpecimen.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 Specimen A resource in the bundle
    .... entry:mcodeProcedures SΣC 0..* BackboneElement FHIR Procedure Resources, if they exist for the patient, including but not limited to: CancerRelatedSurgicalProcedure and RadiotherapyCourseSummary.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 Procedure A resource in the bundle
    .... entry:mcodeBodyStructures SΣC 0..* BackboneElement FHIR BodyStructure Resources, if they exist for the patient, including but not limited to: RadiotherapyVolume and Tumor.
    bdl-5: must be a resource unless there's a request or response
    bdl-8: fullUrl cannot be a version specific reference
    ele-1: All FHIR elements must have a @value or children
    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
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... resource Σ 0..1 BodyStructure A resource in the bundle

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Bundle.typerequiredPattern: collection
    http://hl7.org/fhir/ValueSet/bundle-type|4.0.1
    from the FHIR Standard

     

    Other representations of profile: CSV, Excel, Schematron