SMART Health Cards: Vaccination & Testing Implementation Guide
1.0.0 - STU1 Release International flag

SMART Health Cards: Vaccination & Testing Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-shc-vaccination-ig/ and changes regularly. See the Directory of published versions

Resource Profile: SHCInfectiousDiseaseLaboratoryBundleDM - Detailed Descriptions

Draft as of 2024-12-04

Definitions for the shc-infectious-disease-laboratory-bundle-dm resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Bundle
2. Bundle.id
Definition

It is not necessary to provide an id for Bundles profiled in this IG. This element SHOULD be omitted for data minimization reasons.

ShortShould be omitted
Comments

n/a

Control0..0
Invariantsvc-should-be-omitted: SHOULD be omitted for data minimization. ($this.length() = 0)
4. Bundle.meta
Control0..0
6. Bundle.implicitRules
Control0..0
8. Bundle.language
Control0..0
10. Bundle.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
12. Bundle.type
Must Supporttrue
Fixed Valuecollection
14. Bundle.timestamp
Control0..0
16. Bundle.total
Control0..0
18. Bundle.link
Control0..0
20. Bundle.entry
Control2..?
Must Supporttrue
SlicingThis element introduces a set of slices on Bundle.entry. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ resource
  • 22. Bundle.entry.id
    Definition

    For data minimization reasons, this element SHOULD NOT be populated when generating a resource conforming to this profile for inclusion in one of the Bundles profiled in this IG.

    ShortShould not be populated
    Comments

    Not including id may result in FHIR validation errors of resources. These errors can be ignored for the purposes of assessing conformance to this IG.

    Control0..0
    24. Bundle.entry.extension
    Control0..0
    26. Bundle.entry.modifierExtension
    Control0..0
    28. Bundle.entry.link
    Control0..0
    30. Bundle.entry.fullUrl
    Definition

    Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

    ShortLocally unique identifier like resource:0
    Comments

    n/a

    Control1..?
    Must Supporttrue
    32. Bundle.entry.resource
    Must Supporttrue
    34. Bundle.entry.search
    Control0..0
    36. Bundle.entry.request
    Control0..0
    38. Bundle.entry.response
    Control0..0
    40. Bundle.entry:patient
    Slice Namepatient
    Definition

    The patient who is the subject of the Bundle

    ShortPatient
    Control1..1
    Must Supporttrue
    42. Bundle.entry:patient.id
    Control0..0
    44. Bundle.entry:patient.extension
    Control0..0
    46. Bundle.entry:patient.modifierExtension
    Control0..0
    48. Bundle.entry:patient.link
    Control0..0
    50. Bundle.entry:patient.fullUrl
    Definition

    Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

    ShortLocally unique identifier like resource:0
    Comments

    n/a

    Control1..?
    Must Supporttrue
    Invariantsvc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
    52. Bundle.entry:patient.resource
    Control1..?
    TypePatient(Patient Profile - General - Data Minimization)
    54. Bundle.entry:patient.search
    Control0..0
    56. Bundle.entry:patient.request
    Control0..0
    58. Bundle.entry:patient.response
    Control0..0
    60. Bundle.entry:labResult
    Slice NamelabResult
    Definition

    Laboratory result

    ShortLaboratory result
    Control1..*
    Must Supporttrue
    Invariantsvc-bundle-lab-status-complete: Bundle SHALL only include results with status final or status that is subsequent to final. ($this.resource.ofType(Observation).status.lower() in ('final'|'amended'|'corrected'))
    62. Bundle.entry:labResult.id
    Control0..0
    64. Bundle.entry:labResult.extension
    Control0..0
    66. Bundle.entry:labResult.modifierExtension
    Control0..0
    68. Bundle.entry:labResult.link
    Control0..0
    70. Bundle.entry:labResult.fullUrl
    Definition

    Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

    ShortLocally unique identifier like resource:0
    Comments

    n/a

    Control1..?
    Must Supporttrue
    Invariantsvc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
    72. Bundle.entry:labResult.resource
    Control1..?
    TypeObservation(Generic Laboratory Result Observation Profile - Data Minimization)
    74. Bundle.entry:labResult.search
    Control0..0
    76. Bundle.entry:labResult.request
    Control0..0
    78. Bundle.entry:labResult.response
    Control0..0
    80. Bundle.signature
    Control0..0

    Guidance on how to interpret the contents of this table can be found here

    0. Bundle
    Definition

    A container for a collection of resources.

    ShortContains a collection of resources
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsbdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
    bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset'))
    bdl-3: 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: 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-7: 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-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
    bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
    bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
    bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
    bdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
    bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset'))
    bdl-3: 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: 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-7: 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-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
    bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
    bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
    bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
    2. Bundle.id
    Definition

    It is not necessary to provide an id for Bundles profiled in this IG. This element SHOULD be omitted for data minimization reasons.


    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortShould be omittedLogical id of this artifact
    Comments

    n/a


    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

    Control0..01
    Typeidstring
    Is Modifierfalse
    Summarytrue
    Invariantsvc-should-be-omitted: SHOULD be omitted for data minimization. ($this.length() = 0)
    4. Bundle.meta
    Definition

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

    ShortMetadata about the resource
    Control0..01
    TypeMeta
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. Bundle.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..01
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Bundle.language
    Definition

    The base language in which the resource is written.

    ShortLanguage of the resource content
    Comments

    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

    Control0..01
    BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Bundle.identifier
    Definition

    A persistent identifier for the bundle that won't change as a bundle is copied from server to server.

    ShortPersistent identifier for the bundle
    Comments

    Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..01
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Bundle.type
    Definition

    Indicates the purpose of this bundle - how it is intended to be used.

    Shortdocument | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
    Comments

    It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

    Control1..1
    BindingThe codes SHALL be taken from BundleTypehttp://hl7.org/fhir/ValueSet/bundle-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

    Indicates the purpose of a bundle - how it is intended to be used.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Fixed Valuecollection
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Bundle.timestamp
    Definition

    The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.

    ShortWhen the bundle was assembled
    Comments

    For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.

    Usage:

    • document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
    • message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
    • history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
    • searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
    • transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning

    The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.

    Control0..01
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Bundle.total
    Definition

    If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle.

    ShortIf search, the total number of matches
    Comments

    Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.

    Control0..01
    This element is affected by the following invariants: bdl-1
    TypeunsignedInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Bundle.link
    Definition

    A series of links that provide context to this bundle.

    ShortLinks related to this Bundle
    Comments

    Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS).

    Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly.

    This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.

    Control0..0*
    TypeBackboneElement
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    23. Bundle.entry
    Definition

    An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

    ShortEntry in the bundle - will have a resource or information
    Control20..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
    bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
    bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
    SlicingThis element introduces a set of slices on Bundle.entry. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ resource
    • 25. Bundle.entry.id
      Definition

      For data minimization reasons, this element SHOULD NOT be populated when generating a resource conforming to this profile for inclusion in one of the Bundles profiled in this IG.


      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortShould not be populatedUnique id for inter-element referencing
      Comments

      Not including id may result in FHIR validation errors of resources. These errors can be ignored for the purposes of assessing conformance to this IG.

      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      27. Bundle.entry.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      29. Bundle.entry.modifierExtension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensionExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      31. Bundle.entry.link
      Definition

      A series of links that provide context to this entry.

      ShortLinks related to this entry
      Control0..0*
      TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      33. Bundle.entry.fullUrl
      Definition

      Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.


      The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:

      • fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
      • Results from operations might involve resources that are not identified.
      ShortLocally unique identifier like resource:0URI for resource (Absolute URL server address or URI for UUID/OID)
      Comments

      n/a


      fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

      Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      35. Bundle.entry.resource
      Definition

      The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

      ShortA resource in the bundle
      Control0..1
      TypeResource
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      37. Bundle.entry.search
      Definition

      Information about the search process that lead to the creation of this entry.

      ShortSearch related information
      Control0..01
      This element is affected by the following invariants: bdl-2
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Bundle.entry.request
      Definition

      Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

      ShortAdditional execution information (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-3
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      45. Bundle.entry.response
      Definition

      Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

      ShortResults of execution (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-4
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      49. Bundle.entry:patient
      Slice Namepatient
      Definition

      The patient who is the subject of the Bundle


      An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

      ShortPatientEntry in the bundle - will have a resource or information
      Control10..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      51. Bundle.entry:patient.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      53. Bundle.entry:patient.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      55. Bundle.entry:patient.modifierExtension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensionExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      57. Bundle.entry:patient.link
      Definition

      A series of links that provide context to this entry.

      ShortLinks related to this entry
      Control0..0*
      TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      59. Bundle.entry:patient.fullUrl
      Definition

      Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.


      The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:

      • fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
      • Results from operations might involve resources that are not identified.
      ShortLocally unique identifier like resource:0URI for resource (Absolute URL server address or URI for UUID/OID)
      Comments

      n/a


      fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

      Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      vc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
      61. Bundle.entry:patient.resource
      Definition

      Demographics and other administrative information about an individual receiving a vaccination or infectious disease-related laboratory test.


      The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

      ShortInformation about an individual receiving an individual receiving a vaccination or infectious disease-related laboratory testA resource in the bundle
      Control10..1
      TypePatientResource(Patient Profile - General - Data Minimization)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesSubjectOfCare Client Resident
      63. Bundle.entry:patient.search
      Definition

      Information about the search process that lead to the creation of this entry.

      ShortSearch related information
      Control0..01
      This element is affected by the following invariants: bdl-2
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. Bundle.entry:patient.request
      Definition

      Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

      ShortAdditional execution information (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-3
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      71. Bundle.entry:patient.response
      Definition

      Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

      ShortResults of execution (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-4
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      75. Bundle.entry:labResult
      Slice NamelabResult
      Definition

      Laboratory result


      An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

      ShortLaboratory resultEntry in the bundle - will have a resource or information
      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      vc-bundle-lab-status-complete: Bundle SHALL only include results with status final or status that is subsequent to final. ($this.resource.ofType(Observation).status.lower() in ('final'|'amended'|'corrected'))
      bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      77. Bundle.entry:labResult.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      79. Bundle.entry:labResult.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      81. Bundle.entry:labResult.modifierExtension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensionExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      83. Bundle.entry:labResult.link
      Definition

      A series of links that provide context to this entry.

      ShortLinks related to this entry
      Control0..0*
      TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      85. Bundle.entry:labResult.fullUrl
      Definition

      Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.


      The Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:

      • fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
      • Results from operations might involve resources that are not identified.
      ShortLocally unique identifier like resource:0URI for resource (Absolute URL server address or URI for UUID/OID)
      Comments

      n/a


      fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

      Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      vc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
      87. Bundle.entry:labResult.resource
      Definition

      Measurements and simple assertions made about a patient, device or other subject.


      The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

      ShortMeasurements and simple assertionsA resource in the bundle
      Comments

      Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

      Control10..1
      TypeObservationResource(Generic Laboratory Result Observation Profile - Data Minimization)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesVital Signs, Measurement, Results, Tests
      89. Bundle.entry:labResult.search
      Definition

      Information about the search process that lead to the creation of this entry.

      ShortSearch related information
      Control0..01
      This element is affected by the following invariants: bdl-2
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      92. Bundle.entry:labResult.request
      Definition

      Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

      ShortAdditional execution information (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-3
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      97. Bundle.entry:labResult.response
      Definition

      Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

      ShortResults of execution (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: bdl-4
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      101. Bundle.signature
      Definition

      Digital Signature - base64 encoded. XML-DSig or a JWT.

      ShortDigital Signature
      Comments

      The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.

      Control0..01
      TypeSignature
      Is Modifierfalse
      Summarytrue
      Requirements

      A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Bundle
      Definition

      A container for a collection of resources.

      ShortContains a collection of resources
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsbdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
      bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset'))
      bdl-3: 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: 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-7: 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-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
      bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
      bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
      bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
      2. Bundle.id
      Definition

      It is not necessary to provide an id for Bundles profiled in this IG. This element SHOULD be omitted for data minimization reasons.

      ShortShould be omitted
      Comments

      n/a

      Control0..0
      Typeid
      Is Modifierfalse
      Summarytrue
      Invariantsvc-should-be-omitted: SHOULD be omitted for data minimization. ($this.length() = 0)
      4. Bundle.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..0
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Bundle.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..0
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Bundle.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..0
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Bundle.identifier
      Definition

      A persistent identifier for the bundle that won't change as a bundle is copied from server to server.

      ShortPersistent identifier for the bundle
      Comments

      Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Bundle.type
      Definition

      Indicates the purpose of this bundle - how it is intended to be used.

      Shortdocument | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
      Comments

      It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

      Control1..1
      BindingThe codes SHALL be taken from BundleType
      (required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

      Indicates the purpose of a bundle - how it is intended to be used.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Fixed Valuecollection
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Bundle.timestamp
      Definition

      The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.

      ShortWhen the bundle was assembled
      Comments

      For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.

      Usage:

      • document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
      • message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
      • history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
      • searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
      • transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning

      The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.

      Control0..0
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Bundle.total
      Definition

      If a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle.

      ShortIf search, the total number of matches
      Comments

      Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.

      Control0..0
      This element is affected by the following invariants: bdl-1
      TypeunsignedInt
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Bundle.link
      Definition

      A series of links that provide context to this bundle.

      ShortLinks related to this Bundle
      Comments

      Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS).

      Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly.

      This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.

      Control0..0
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      25. Bundle.entry
      Definition

      An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

      ShortEntry in the bundle - will have a resource or information
      Control2..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Bundle.entry. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ resource
      • 27. Bundle.entry.id
        Definition

        For data minimization reasons, this element SHOULD NOT be populated when generating a resource conforming to this profile for inclusion in one of the Bundles profiled in this IG.

        ShortShould not be populated
        Comments

        Not including id may result in FHIR validation errors of resources. These errors can be ignored for the purposes of assessing conformance to this IG.

        Control0..0
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        29. Bundle.entry.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        31. Bundle.entry.modifierExtension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        33. Bundle.entry.link
        Definition

        A series of links that provide context to this entry.

        ShortLinks related to this entry
        Control0..0
        TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        35. Bundle.entry.fullUrl
        Definition

        Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

        ShortLocally unique identifier like resource:0
        Comments

        n/a

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        37. Bundle.entry.resource
        Definition

        The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

        ShortA resource in the bundle
        Control0..1
        TypeResource
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        39. Bundle.entry.search
        Definition

        Information about the search process that lead to the creation of this entry.

        ShortSearch related information
        Control0..0
        This element is affected by the following invariants: bdl-2
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Bundle.entry.request
        Definition

        Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

        ShortAdditional execution information (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-3
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        57. Bundle.entry.response
        Definition

        Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

        ShortResults of execution (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-4
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        67. Bundle.entry:patient
        Slice Namepatient
        Definition

        The patient who is the subject of the Bundle

        ShortPatient
        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
        bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        69. Bundle.entry:patient.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..0
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        71. Bundle.entry:patient.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        73. Bundle.entry:patient.modifierExtension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        75. Bundle.entry:patient.link
        Definition

        A series of links that provide context to this entry.

        ShortLinks related to this entry
        Control0..0
        TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        77. Bundle.entry:patient.fullUrl
        Definition

        Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

        ShortLocally unique identifier like resource:0
        Comments

        n/a

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        vc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
        79. Bundle.entry:patient.resource
        Definition

        Demographics and other administrative information about an individual receiving a vaccination or infectious disease-related laboratory test.

        ShortInformation about an individual receiving an individual receiving a vaccination or infectious disease-related laboratory test
        Control1..1
        TypePatient(Patient Profile - General - Data Minimization)
        Is Modifierfalse
        Summaryfalse
        Alternate NamesSubjectOfCare Client Resident
        81. Bundle.entry:patient.search
        Definition

        Information about the search process that lead to the creation of this entry.

        ShortSearch related information
        Control0..0
        This element is affected by the following invariants: bdl-2
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Bundle.entry:patient.request
        Definition

        Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

        ShortAdditional execution information (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-3
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        99. Bundle.entry:patient.response
        Definition

        Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

        ShortResults of execution (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-4
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        109. Bundle.entry:labResult
        Slice NamelabResult
        Definition

        Laboratory result

        ShortLaboratory result
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
        bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        vc-bundle-lab-status-complete: Bundle SHALL only include results with status final or status that is subsequent to final. ($this.resource.ofType(Observation).status.lower() in ('final'|'amended'|'corrected'))
        111. Bundle.entry:labResult.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..0
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        113. Bundle.entry:labResult.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        115. Bundle.entry:labResult.modifierExtension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        117. Bundle.entry:labResult.link
        Definition

        A series of links that provide context to this entry.

        ShortLinks related to this entry
        Control0..0
        TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        119. Bundle.entry:labResult.fullUrl
        Definition

        Identifier for the contained resource that is locally unique within this Bundle. The identifier SHALL use resource:# format, where # is an integer incremented from 0 to n within the Bundle.

        ShortLocally unique identifier like resource:0
        Comments

        n/a

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        vc-shall-be-resource-uri: IDs SHALL use resource:# format ($this.matches('^resource:[0-9]+$'))
        121. Bundle.entry:labResult.resource
        Definition

        Measurements and simple assertions made about a patient, device or other subject.

        ShortMeasurements and simple assertions
        Comments

        Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

        Control1..1
        TypeObservation(Generic Laboratory Result Observation Profile - Data Minimization)
        Is Modifierfalse
        Summaryfalse
        Alternate NamesVital Signs, Measurement, Results, Tests
        123. Bundle.entry:labResult.search
        Definition

        Information about the search process that lead to the creation of this entry.

        ShortSearch related information
        Control0..0
        This element is affected by the following invariants: bdl-2
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        130. Bundle.entry:labResult.request
        Definition

        Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

        ShortAdditional execution information (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-3
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        141. Bundle.entry:labResult.response
        Definition

        Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

        ShortResults of execution (transaction/batch/history)
        Control0..0
        This element is affected by the following invariants: bdl-4
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        151. Bundle.signature
        Definition

        Digital Signature - base64 encoded. XML-DSig or a JWT.

        ShortDigital Signature
        Comments

        The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.

        Control0..0
        TypeSignature
        Is Modifierfalse
        Summarytrue
        Requirements

        A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))