National Directory of Healthcare Providers & Services (NDH) Implementation Guide
2.0.0-current - ci-build

National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 2.0.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

## Resource Profile: NdhGroup - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 4

Definitions for the ndh-Group resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Group
Definition | Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.
Short | Group of multiple entities
Comments | If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) grp-1: Can only have members if group is "actual" (`member.empty() or (actual = true)`) grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
2. Group.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Group.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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())
Slicing | This element introduces a set of slices on `Group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Group.extension:location
Slice Name | location
Definition | A reference to a Location resource (NDH-Location) defining the coverage area of a health insurance provider network
Short | Network coverage area
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(NDH Location Reference) (Extension Type: Reference(NDH Location Profile))
Is Modifier | false
Summary | false
Invariants | ele-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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Group.extension:endpoint
Slice Name | endpoint
Definition | The technical details of an endpoint that can be used for electronic services
Short | Endpoint Reference
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(NDH Endpoint Reference) (Extension Type: Reference(NDH Endpoint Profile))
Is Modifier | false
Summary | false
Invariants | ele-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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Group.extension:verification-status
Slice Name | verification-status
Definition | Indicates a resource instance verification status
Short | Group Verification Status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(NDH Verification Status) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Group.extension:artifact-description
Slice Name | artifact-description
Definition | A free text natural language description of the artifact from a consumer's perspective.
Short | Group Description
Comments | This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the artifact as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the artifact is presumed to be the predominant language in the place the artifact was created).
Control | 0..1
Type | Extension(Artifact Description) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | ele-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()`) ele-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())
14. Group.extension:artifact-effectivePeriod
Slice Name | artifact-effectivePeriod
Definition | The period during which the artifact content was or is planned to be in active use.
Short | Group Effective Period
Comments | The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Extension(Artifact Effective Period) (Extension Type: Period)
Is Modifier | false
Summary | false
Invariants | ele-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()`) ele-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())
16. Group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).
Short | Extensions that cannot be ignored
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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())
18. Group.identifier
Definition | A unique business identifier for this group.
Short | Unique id
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows the group to be referenced from external specifications.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Group.active
Definition | Indicates whether the record for the group is available for use or is merely being retained for historical purposes.
Short | Whether this group's record is in active use
Control | 10..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Fixed Value | `true`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Group.type
Definition | Identifies the broad classification of the kind of resources the group includes.
Short | person | animal | practitioner | device | medication | substance
Comments | Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).
Control | 1..1
Binding | The codes SHALL be taken from GroupType http://hl7.org/fhir/ValueSet/group-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/group-type|4.0.1` ) Types of resources that are part of group.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Identifies what type of resources the group is made up of.
Fixed Value | `practitioner`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Group.actual
Definition | If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.
Short | Descriptive or actual
Control | 1..1 This element is affected by the following invariants: grp-1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.
Fixed Value | `true`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Group.code
Definition | Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.
Short | Kind of Group members
Comments | This would generally be omitted for Person resources.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Healthcare Service Category Value Set (extensible to `http://hl7.org/fhir/us/ndh/ValueSet/HealthcareServiceCategoryVS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Group.name
Definition | A label assigned to the group for human identification and communication.
Short | Label for Group
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Used to identify the group in human communication.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Group.managingEntity
Definition | Entity responsible for defining and maintaining Group characteristics and/or registered members.
Short | Entity that is the custodian of the Group's definition
Comments | This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.
Control | 0..1
Type | Reference(NDH Organization Profile, Organization, RelatedPerson, Practitioner, PractitionerRole)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Group.member
Definition | Identifies the resource instances that are members of the group.
Short | Who or what is in group
Control | 0..* This element is affected by the following invariants: grp-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Often the only thing of interest about a group is "who's in it".
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Group.member.modifierExtension
Definition | 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
36. Group.member.entity
Definition | A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.
Short | Reference to the group member
Control | 1..1
Type | Reference(NDH Practitioner Profile, NDH PractitionerRole, Patient, Practitioner, PractitionerRole, Device, Medication, Substance, Group)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Group.member.period
Definition | The period that the member was in the group, if known.
Short | Period member belonged to the group
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | false
Requirements | Need to track who was in a group at a particular time.
Meaning if Missing | The member is in the group at this time
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Group.member.inactive
Definition | A flag to indicate that the member is no longer in the group, but previously may have been a member.
Short | If member is no longer in group
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Sometimes you don't know when someone stopped being in a group, but not when.
Meaning if Missing | Members are considered active unless explicitly specified otherwise
Invariants | ele-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 foundhere

0. Group
2. Group.meta
4. Group.meta.lastUpdated
Control | 1..?
6. Group.extension
Slicing | This element introduces a set of slices on `Group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. Group.extension:location
Slice Name | location
Short | Network coverage area
Control | 0..*
Type | Extension(NDH Location Reference) (Extension Type: Reference(NDH Location Profile))
10. Group.extension:endpoint
Slice Name | endpoint
Short | Endpoint Reference
Control | 0..*
Type | Extension(NDH Endpoint Reference) (Extension Type: Reference(NDH Endpoint Profile))
12. Group.extension:verification-status
Slice Name | verification-status
Short | Group Verification Status
Control | 0..1
Type | Extension(NDH Verification Status) (Extension Type: CodeableConcept)
14. Group.extension:artifact-description
Slice Name | artifact-description
Short | Group Description
Control | 0..1
Type | Extension(Artifact Description) (Extension Type: markdown)
16. Group.extension:artifact-effectivePeriod
Slice Name | artifact-effectivePeriod
Short | Group Effective Period
Control | 0..1
Type | Extension(Artifact Effective Period) (Extension Type: Period)
18. Group.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
20. Group.active
Control | 1..?
Must Support | true
Fixed Value | `true`
22. Group.type
Fixed Value | `practitioner`
24. Group.actual
Fixed Value | `true`
26. Group.code
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from Healthcare Service Category Value Set (extensible to `http://hl7.org/fhir/us/ndh/ValueSet/HealthcareServiceCategoryVS` )
Must Support | true
28. Group.name
Control | 1..?
Must Support | true
30. Group.managingEntity
Type | Reference(NDH Organization Profile)
Must Support | true
32. Group.member
Must Support | true
34. Group.member.entity
Type | Reference(NDH Practitioner Profile, NDH PractitionerRole)
36. Group.member.period
Must Support | true
38. Group.member.inactive
Must Support | true

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

0. Group
Definition | Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.
Short | Group of multiple entities
Comments | If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) grp-1: Can only have members if group is "actual" (`member.empty() or (actual = true)`)
2. Group.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Group.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Group.meta.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
8. Group.meta.extension
Definition | 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `Group.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Group.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Group.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 1..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. Group.meta.source
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. Group.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. Group.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Group.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. Group.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Group.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Group.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. Group.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
30. Group.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `Group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Group.extension:location
Slice Name | location
Definition | A reference to a Location resource (NDH-Location) defining the coverage area of a health insurance provider network
Short | Network coverage area
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(NDH Location Reference) (Extension Type: Reference(NDH Location Profile))
Is Modifier | false
Summary | false
Invariants | ele-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()`)
34. Group.extension:endpoint
Slice Name | endpoint
Definition | The technical details of an endpoint that can be used for electronic services
Short | Endpoint Reference
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(NDH Endpoint Reference) (Extension Type: Reference(NDH Endpoint Profile))
Is Modifier | false
Summary | false
Invariants | ele-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()`)
36. Group.extension:verification-status
Slice Name | verification-status
Definition | Indicates a resource instance verification status
Short | Group Verification Status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(NDH Verification Status) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-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()`)
38. Group.extension:artifact-description
Slice Name | artifact-description
Definition | A free text natural language description of the artifact from a consumer's perspective.
Short | Group Description
Comments | This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the artifact as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the artifact is presumed to be the predominant language in the place the artifact was created).
Control | 0..1
Type | Extension(Artifact Description) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | ele-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()`)
40. Group.extension:artifact-effectivePeriod
Slice Name | artifact-effectivePeriod
Definition | The period during which the artifact content was or is planned to be in active use.
Short | Group Effective Period
Comments | The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Extension(Artifact Effective Period) (Extension Type: Period)
Is Modifier | false
Summary | false
Invariants | ele-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()`)
42. Group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).
Short | Extensions that cannot be ignored
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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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()`)
44. Group.identifier
Definition | A unique business identifier for this group.
Short | Unique id
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows the group to be referenced from external specifications.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Group.active
Definition | Indicates whether the record for the group is available for use or is merely being retained for historical purposes.
Short | Whether this group's record is in active use
Control | 1..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Fixed Value | `true`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Group.type
Definition | Identifies the broad classification of the kind of resources the group includes.
Short | person | animal | practitioner | device | medication | substance
Comments | Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).
Control | 1..1
Binding | The codes SHALL be taken from GroupType (required to `http://hl7.org/fhir/ValueSet/group-type|4.0.1` ) Types of resources that are part of group.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Identifies what type of resources the group is made up of.
Fixed Value | `practitioner`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Group.actual
Definition | If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.
Short | Descriptive or actual
Control | 1..1 This element is affected by the following invariants: grp-1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.
Fixed Value | `true`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Group.code
Definition | Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.
Short | Kind of Group members
Comments | This would generally be omitted for Person resources.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Healthcare Service Category Value Set (extensible to `http://hl7.org/fhir/us/ndh/ValueSet/HealthcareServiceCategoryVS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Group.name
Definition | A label assigned to the group for human identification and communication.
Short | Label for Group
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Used to identify the group in human communication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Group.quantity
Definition | A count of the number of resource instances that are part of the group.
Short | Number of members
Comments | Note that the quantity may be less than the number of members if some of the members are not active.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Group size is a common defining characteristic.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Group.managingEntity
Definition | Entity responsible for defining and maintaining Group characteristics and/or registered members.
Short | Entity that is the custodian of the Group's definition
Comments | This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.
Control | 0..1
Type | Reference(NDH Organization Profile)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Group.characteristic
Definition | Identifies traits whose presence r absence is shared by members of the group.
Short | Include / Exclude group members by Trait
Comments | All the identified characteristics must be true for an entity to a member of the group.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Needs to be a generic mechanism for identifying what individuals can be part of a group.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Group.characteristic.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
64. Group.characteristic.extension
Definition | 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
66. Group.characteristic.modifierExtension
Definition | 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
68. Group.characteristic.code
Definition | A code that identifies the kind of trait being asserted.
Short | Kind of characteristic
Control | 1..1
Binding | List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need a formal way of identifying the characteristic being described.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Group.characteristic.value[x]
Definition | The value of the trait that holds (or does not hold - see 'exclude') for members of the group.
Short | Value held by characteristic
Comments | For Range, it means members of the group have a value that falls somewhere within the specified range.
Control | 1..1
Binding | Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.
Type | Choice of: CodeableConcept, boolean, Quantity, Range, Reference
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | The value of the characteristic is what determines group membership.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Group.characteristic.exclude
Definition | If true, indicates the characteristic is one that is NOT held by members of the group.
Short | Group includes or excludes
Comments | This is labeled as "Is Modifier" because applications cannot wrongly include excluded members as included or vice versa.
Control | 1..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sometimes group membership is determined by characteristics not possessed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Group.characteristic.period
Definition | The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.
Short | Period over which characteristic is tested
Control | 0..1
Type | Period
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Group.member
Definition | Identifies the resource instances that are members of the group.
Short | Who or what is in group
Control | 0..* This element is affected by the following invariants: grp-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Often the only thing of interest about a group is "who's in it".
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Group.member.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
80. Group.member.extension
Definition | 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
82. Group.member.modifierExtension
Definition | 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
84. Group.member.entity
Definition | A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.
Short | Reference to the group member
Control | 1..1
Type | Reference(NDH Practitioner Profile, NDH PractitionerRole)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Group.member.period
Definition | The period that the member was in the group, if known.
Short | Period member belonged to the group
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | false
Requirements | Need to track who was in a group at a particular time.
Meaning if Missing | The member is in the group at this time
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Group.member.inactive
Definition | A flag to indicate that the member is no longer in the group, but previously may have been a member.
Short | If member is no longer in group
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Sometimes you don't know when someone stopped being in a group, but not when.
Meaning if Missing | Members are considered active unless explicitly specified otherwise
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)