DK MedCom Messaging
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DK MedCom Messaging, published by MedCom. This guide is not an authorized publication; it is the continuous build for version 4.0.0-trial-use built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/medcomdk/dk-medcom-messaging/ and changes regularly. See the Directory of published versions

Resource Profile: MedComMessagingMessageHeader - Detailed Descriptions

Draft as of 2025-09-25

Definitions for the medcom-messaging-messageHeader resource profile.

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

0. MessageHeader
Definition

The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle.

ShortA resource that describes a message that is exchanged between systems
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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())
2. MessageHeader.id
Definition

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

ShortEach message shall include a globally unique id.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.

Control10..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:in-narrativeProducer of FHIR resources
    Summarytrue
    4. MessageHeader.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..1
    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()))
    6. MessageHeader.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.

    ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.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.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. MessageHeader.text.status
    Definition

    The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

    Shortgenerated | extensions | additional | empty
    Control1..1
    BindingThe codes SHALL be taken from NarrativeStatushttp://hl7.org/fhir/ValueSet/narrative-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

    The status of a resource narrative.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. MessageHeader.text.div
    Definition

    The actual narrative content, a stripped down version of XHTML.

    ShortLimited xhtml content
    Comments

    The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

    Control1..1
    Typexhtml
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    12. MessageHeader.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).

    ShortExtensions 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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    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
    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())
    14. MessageHeader.event[x]
    Definition

    Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition.

    ShortThe event element shall contain a value from MedComMessagingMessageTypesCode for the event this message represents or link to event definition
    Comments

    The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp.


    The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp.

    Control1..1
    BindingThe codes SHALL be taken from For example codes, see MedComMessagingMessageTypeshttp://hl7.org/fhir/ValueSet/message-events|4.0.1
    (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-messageTypes)
    TypeCoding, uri
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Drives the behavior associated with this message.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. MessageHeader.event[x].system
    Definition

    The identification of the code system that defines the meaning of the symbol in the code.

    ShortIdentity of the terminology system
    Comments

    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

    Control10..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to be unambiguous about the source of the definition of the symbol.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. MessageHeader.event[x].code
    Definition

    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

    ShortSymbol in syntax defined by the system
    Control10..1
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:in-narrativeProducer of FHIR resources
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

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

      The destination application which the message is intended for.

      ShortMessage destination application(s)
      Comments

      There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MessageHeader.destination. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • value @ extension('http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension').value.code
      • 22. MessageHeader.destination.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).

        ShortExtensions 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..*
        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())
        24. MessageHeader.destination.endpoint
        Definition

        Indicates where the message should be routed to.

        ShortActual destination address or id
        Comments

        The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

        Control1..1
        Typeurl
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Identifies where to route the message.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MessageHeader.destination:primary
        Slice Nameprimary
        Definition

        The destination application which the message is intended for.

        ShortMessage destination application(s)
        Comments

        There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

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

        Control10..*
        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())
        SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 30. MessageHeader.destination:primary.extension:use
          Slice Nameuse
          Definition

          Indicates whether the use of a destination in a MedCom message header is as a primary or a carbon copy recipient of the message

          ShortMedComDestinationUseExtension
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
          Is Modifierfalse
          Must Supporttrue
          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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          32. MessageHeader.destination:primary.extension:use.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())
          SlicingThis element introduces a set of slices on MessageHeader.destination.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 34. MessageHeader.destination:primary.extension:use.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttp://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension
            36. MessageHeader.destination:primary.extension:use.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. MessageHeader.destination:primary.extension:use.value[x].system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be unambiguous about the source of the definition of the symbol.

            Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. MessageHeader.destination:primary.extension:use.value[x].code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortSymbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActorSource
              SHALL:in-narrativeProducer of FHIR resourcesfrom MedComDestinationUseExtension
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Pattern Valueprimary
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. MessageHeader.destination:primary.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).

              ShortExtensions 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..*
              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())
              44. MessageHeader.destination:primary.endpoint
              Definition

              Indicates where the message should be routed to.

              ShortActual destination address or id
              Comments

              The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

              Control1..1
              Typeurl
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:in-narrativeProducer of FHIR resources
                Summarytrue
                Requirements

                Identifies where to route the message.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. MessageHeader.destination:primary.receiver
                Definition

                Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.

                ShortThe primary reciever of the messageIntended "real-world" recipient for the data
                Control10..1
                TypeReference(MedComMessagingOrganization, Practitioner, PractitionerRole, Organization)bundled
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:in-narrativeProducer of FHIR resources
                  Summarytrue
                  Requirements

                  Allows routing beyond just the application level.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. MessageHeader.destination:cc
                  Slice Namecc
                  Definition

                  The destination application which the message is intended for.

                  ShortMessage destination application(s)
                  Comments

                  There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

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

                  Control10..*
                  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())
                  SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 52. MessageHeader.destination:cc.extension:use
                    Slice Nameuse
                    Definition

                    Indicates whether the use of a destination in a MedCom message header is as a primary or a carbon copy recipient of the message

                    ShortMedComDestinationUseExtension
                    Control1..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
                    Is Modifierfalse
                    Must Supporttrue
                    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())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    54. MessageHeader.destination:cc.extension:use.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())
                    SlicingThis element introduces a set of slices on MessageHeader.destination.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 56. MessageHeader.destination:cc.extension:use.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension
                      58. MessageHeader.destination:cc.extension:use.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control10..1
                      TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      60. MessageHeader.destination:cc.extension:use.value[x].system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control10..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      62. MessageHeader.destination:cc.extension:use.value[x].code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control10..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Obligations
                        ObligationsActorSource
                        SHALL:in-narrativeProducer of FHIR resourcesfrom MedComDestinationUseExtension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        Pattern Valuecc
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        64. MessageHeader.destination:cc.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).

                        ShortExtensions 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..*
                        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())
                        66. MessageHeader.destination:cc.endpoint
                        Definition

                        Indicates where the message should be routed to.

                        ShortActual destination address or id
                        Comments

                        The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                        Control1..1
                        Typeurl
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:in-narrativeProducer of FHIR resources
                          Summarytrue
                          Requirements

                          Identifies where to route the message.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. MessageHeader.destination:cc.receiver
                          Definition

                          Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.

                          ShortThe carbon copy reciever of the message. Is only used when a message has multiple recievers.Intended "real-world" recipient for the data
                          Control10..1
                          TypeReference(MedComMessagingOrganization, Practitioner, PractitionerRole, Organization)bundled
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:in-narrativeProducer of FHIR resources
                            Summarytrue
                            Requirements

                            Allows routing beyond just the application level.

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

                            Identifies the sending system to allow the use of a trust relationship.

                            ShortThe actual sender of the messageReal world sender of the message
                            Comments

                            Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone.

                            Control10..1
                            TypeReference(MedComMessagingOrganization, Practitioner, PractitionerRole, Organization)bundled
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:in-narrativeProducer of FHIR resources
                              Summarytrue
                              Requirements

                              Allows routing beyond just the application level.

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

                              The source application from which this message originated.

                              ShortContains the information about the target for the Acknowledgement message.Message source application
                              Control1..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Allows replies, supports audit.

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

                              ShortExtensions 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..*
                              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())
                              76. MessageHeader.source.endpoint
                              Definition

                              Identifies the routing target to send acknowledgements to.

                              ShortActual message source address or id
                              Comments

                              The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                              Control1..1
                              Typeurl
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:in-narrativeProducer of FHIR resources
                                Summarytrue
                                Requirements

                                Identifies where to send responses, may influence security permissions.

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

                                Permanent link to the MessageDefinition for this message.

                                ShortLink to the definition for this message
                                Control0..1
                                Typecanonical(MessageDefinition)
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Allows sender to define the expected contents of the message.

                                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 foundhere

                                0. MessageHeader
                                2. MessageHeader.id
                                ShortEach message shall include a globally unique id.
                                Control1..?
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:in-narrativeProducer of FHIR resources
                                  4. MessageHeader.text
                                  ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
                                  Must Supporttrue
                                  6. MessageHeader.text.status
                                  Must Supporttrue
                                  8. MessageHeader.text.div
                                  Must Supporttrue
                                  10. MessageHeader.event[x]
                                  ShortThe event element shall contain a value from MedComMessagingMessageTypes
                                  BindingThe codes SHALL be taken from MedComMessagingMessageTypes
                                  (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-messageTypes)
                                  TypeCoding, uri
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Must Supporttrue
                                  12. MessageHeader.event[x].system
                                  Control1..?
                                  Must Supporttrue
                                  14. MessageHeader.event[x].code
                                  Control1..?
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:in-narrativeProducer of FHIR resources
                                    16. MessageHeader.destination
                                    Control1..?
                                    Must Supporttrue
                                    SlicingThis element introduces a set of slices on MessageHeader.destination. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                    • value @ extension('http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension').value.code
                                    • 18. MessageHeader.destination:primary
                                      Slice Nameprimary
                                      Control1..1
                                      Must Supporttrue
                                      20. MessageHeader.destination:primary.extension
                                      Control1..?
                                      SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 22. MessageHeader.destination:primary.extension:use
                                        Slice Nameuse
                                        Control1..1
                                        TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
                                        Must Supporttrue
                                        24. MessageHeader.destination:primary.extension:use.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        26. MessageHeader.destination:primary.extension:use.value[x].system
                                        Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
                                        28. MessageHeader.destination:primary.extension:use.value[x].code
                                        Pattern Valueprimary
                                        30. MessageHeader.destination:primary.endpoint
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:in-narrativeProducer of FHIR resources
                                          32. MessageHeader.destination:primary.receiver
                                          ShortThe primary reciever of the message
                                          Control1..?
                                          TypeReference(MedComMessagingOrganization)bundled
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:in-narrativeProducer of FHIR resources
                                            34. MessageHeader.destination:cc
                                            Slice Namecc
                                            Control0..*
                                            Must Supporttrue
                                            36. MessageHeader.destination:cc.extension
                                            Control1..?
                                            SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 38. MessageHeader.destination:cc.extension:use
                                              Slice Nameuse
                                              Control1..1
                                              TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
                                              Must Supporttrue
                                              40. MessageHeader.destination:cc.extension:use.value[x]
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              42. MessageHeader.destination:cc.extension:use.value[x].system
                                              Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
                                              44. MessageHeader.destination:cc.extension:use.value[x].code
                                              Pattern Valuecc
                                              46. MessageHeader.destination:cc.endpoint
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:in-narrativeProducer of FHIR resources
                                                48. MessageHeader.destination:cc.receiver
                                                ShortThe carbon copy reciever of the message. Is only used when a message has multiple recievers.
                                                Control1..?
                                                TypeReference(MedComMessagingOrganization)bundled
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:in-narrativeProducer of FHIR resources
                                                  50. MessageHeader.sender
                                                  ShortThe actual sender of the message
                                                  Control1..?
                                                  TypeReference(MedComMessagingOrganization)bundled
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:in-narrativeProducer of FHIR resources
                                                    52. MessageHeader.source
                                                    ShortContains the information about the target for the Acknowledgement message.
                                                    Must Supporttrue
                                                    54. MessageHeader.source.endpoint
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:in-narrativeProducer of FHIR resources
                                                      56. MessageHeader.definition
                                                      Must Supporttrue

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

                                                      0. MessageHeader
                                                      Definition

                                                      The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle.

                                                      ShortA resource that describes a message that is exchanged between systems
                                                      Control0..*
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsdom-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())
                                                      2. MessageHeader.id
                                                      Definition

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

                                                      ShortEach message shall include a globally unique id.
                                                      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.

                                                      Control1..1
                                                      Typeid
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:in-narrativeProducer of FHIR resources
                                                        Summarytrue
                                                        4. MessageHeader.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..1
                                                        TypeMeta
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        6. MessageHeader.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..1
                                                        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. MessageHeader.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..1
                                                        BindingThe codes SHOULD be taken from CommonLanguages
                                                        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                        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. MessageHeader.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.

                                                        ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
                                                        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.

                                                        Control0..1
                                                        TypeNarrative
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Alternate Namesnarrative, html, xhtml, display
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        12. MessageHeader.text.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..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        14. MessageHeader.text.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.

                                                        ShortAdditional 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..*
                                                        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())
                                                        SlicingThis element introduces a set of slices on MessageHeader.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 16. MessageHeader.text.status
                                                          Definition

                                                          The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                                                          Shortgenerated | extensions | additional | empty
                                                          Control1..1
                                                          BindingThe codes SHALL be taken from NarrativeStatus
                                                          (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

                                                          The status of a resource narrative.

                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          18. MessageHeader.text.div
                                                          Definition

                                                          The actual narrative content, a stripped down version of XHTML.

                                                          ShortLimited xhtml content
                                                          Comments

                                                          The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                                                          Control1..1
                                                          Typexhtml
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                                                          txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                                                          20. MessageHeader.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.

                                                          ShortContained, 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.

                                                          Control0..*
                                                          TypeResource
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesinline resources, anonymous resources, contained resources
                                                          22. MessageHeader.extension
                                                          Definition

                                                          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.

                                                          ShortAdditional 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..*
                                                          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())
                                                          24. MessageHeader.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).

                                                          ShortExtensions 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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                          Summaryfalse
                                                          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
                                                          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())
                                                          26. MessageHeader.event[x]
                                                          Definition

                                                          Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition.

                                                          ShortThe event element shall contain a value from MedComMessagingMessageTypes
                                                          Comments

                                                          The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp.

                                                          Control1..1
                                                          BindingThe codes SHALL be taken from MedComMessagingMessageTypes
                                                          (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-messageTypes)
                                                          TypeCoding
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Drives the behavior associated with this message.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          28. MessageHeader.event[x].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..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          30. MessageHeader.event[x].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.

                                                          ShortAdditional 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..*
                                                          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())
                                                          SlicingThis element introduces a set of slices on MessageHeader.event[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 32. MessageHeader.event[x].system
                                                            Definition

                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                            ShortIdentity of the terminology system
                                                            Comments

                                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                            Control1..1
                                                            Typeuri
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            34. MessageHeader.event[x].version
                                                            Definition

                                                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                            ShortVersion of the system - if relevant
                                                            Comments

                                                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                                            Control0..1
                                                            Typestring
                                                            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()))
                                                            36. MessageHeader.event[x].code
                                                            Definition

                                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                            ShortSymbol in syntax defined by the system
                                                            Control1..1
                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:in-narrativeProducer of FHIR resources
                                                              Summarytrue
                                                              Requirements

                                                              Need to refer to a particular code in the system.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              38. MessageHeader.event[x].display
                                                              Definition

                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                              ShortRepresentation defined by the system
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              40. MessageHeader.event[x].userSelected
                                                              Definition

                                                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                              ShortIf this coding was chosen directly by the user
                                                              Comments

                                                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                              Control0..1
                                                              Typeboolean
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                              The destination application which the message is intended for.

                                                              ShortMessage destination application(s)
                                                              Comments

                                                              There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

                                                              Control1..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Requirements

                                                              Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on MessageHeader.destination. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                              • value @ extension('http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension').value.code
                                                              • 44. MessageHeader.destination.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..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                46. MessageHeader.destination.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.

                                                                ShortAdditional 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..*
                                                                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())
                                                                48. MessageHeader.destination.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).

                                                                ShortExtensions 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..*
                                                                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())
                                                                50. MessageHeader.destination.name
                                                                Definition

                                                                Human-readable name for the target system.

                                                                ShortName of system
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                May be used for routing of response and/or to support audit.

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

                                                                Identifies the target end system in situations where the initial message transmission is to an intermediary system.

                                                                ShortParticular delivery destination within the destination
                                                                Control0..1
                                                                TypeReference(Device)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Supports multi-hop routing.

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

                                                                Indicates where the message should be routed to.

                                                                ShortActual destination address or id
                                                                Comments

                                                                The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                                                                Control1..1
                                                                Typeurl
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                Identifies where to route the message.

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

                                                                Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.

                                                                ShortIntended "real-world" recipient for the data
                                                                Control0..1
                                                                TypeReference(Practitioner, PractitionerRole, Organization)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Allows routing beyond just the application level.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                58. MessageHeader.destination:primary
                                                                Slice Nameprimary
                                                                Definition

                                                                The destination application which the message is intended for.

                                                                ShortMessage destination application(s)
                                                                Comments

                                                                There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

                                                                Control1..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Requirements

                                                                Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                60. MessageHeader.destination:primary.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..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                62. MessageHeader.destination:primary.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control1..*
                                                                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())
                                                                SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 64. MessageHeader.destination:primary.extension:use
                                                                  Slice Nameuse
                                                                  Definition

                                                                  Indicates whether the use of a destination in a MedCom message header is as a primary or a carbon copy recipient of the message

                                                                  ShortMedComDestinationUseExtension
                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  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())
                                                                  66. MessageHeader.destination:primary.extension:use.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..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  68. MessageHeader.destination:primary.extension:use.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())
                                                                  SlicingThis element introduces a set of slices on MessageHeader.destination.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 70. MessageHeader.destination:primary.extension:use.url
                                                                    Definition

                                                                    Source of the definition for the extension code - a logical name or a URL.

                                                                    Shortidentifies the meaning of the extension
                                                                    Comments

                                                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                    Control1..1
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    Fixed Valuehttp://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension
                                                                    72. MessageHeader.destination:primary.extension:use.value[x]
                                                                    Definition

                                                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                    ShortValue of extension
                                                                    Control1..1
                                                                    TypeCoding
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    74. MessageHeader.destination:primary.extension:use.value[x].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..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    76. MessageHeader.destination:primary.extension:use.value[x].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.

                                                                    ShortAdditional 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..*
                                                                    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())
                                                                    SlicingThis element introduces a set of slices on MessageHeader.destination.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 78. MessageHeader.destination:primary.extension:use.value[x].system
                                                                      Definition

                                                                      The identification of the code system that defines the meaning of the symbol in the code.

                                                                      ShortIdentity of the terminology system
                                                                      Comments

                                                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                      Control1..1
                                                                      Typeuri
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

                                                                      Need to be unambiguous about the source of the definition of the symbol.

                                                                      Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      80. MessageHeader.destination:primary.extension:use.value[x].version
                                                                      Definition

                                                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                      ShortVersion of the system - if relevant
                                                                      Comments

                                                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                      Control0..1
                                                                      Typestring
                                                                      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()))
                                                                      82. MessageHeader.destination:primary.extension:use.value[x].code
                                                                      Definition

                                                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                      ShortSymbol in syntax defined by the system
                                                                      Control1..1
                                                                      Typecode
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActorSource
                                                                        SHALL:in-narrativeProducer of FHIR resourcesfrom MedComDestinationUseExtension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to refer to a particular code in the system.

                                                                        Pattern Valueprimary
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        84. MessageHeader.destination:primary.extension:use.value[x].display
                                                                        Definition

                                                                        A representation of the meaning of the code in the system, following the rules of the system.

                                                                        ShortRepresentation defined by the system
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        86. MessageHeader.destination:primary.extension:use.value[x].userSelected
                                                                        Definition

                                                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                        ShortIf this coding was chosen directly by the user
                                                                        Comments

                                                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                        Control0..1
                                                                        Typeboolean
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                                        ShortExtensions 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..*
                                                                        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())
                                                                        90. MessageHeader.destination:primary.name
                                                                        Definition

                                                                        Human-readable name for the target system.

                                                                        ShortName of system
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        May be used for routing of response and/or to support audit.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        92. MessageHeader.destination:primary.target
                                                                        Definition

                                                                        Identifies the target end system in situations where the initial message transmission is to an intermediary system.

                                                                        ShortParticular delivery destination within the destination
                                                                        Control0..1
                                                                        TypeReference(Device)
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Requirements

                                                                        Supports multi-hop routing.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        94. MessageHeader.destination:primary.endpoint
                                                                        Definition

                                                                        Indicates where the message should be routed to.

                                                                        ShortActual destination address or id
                                                                        Comments

                                                                        The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                                                                        Control1..1
                                                                        Typeurl
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                          Summarytrue
                                                                          Requirements

                                                                          Identifies where to route the message.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          96. MessageHeader.destination:primary.receiver
                                                                          Definition

                                                                          Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.

                                                                          ShortThe primary reciever of the message
                                                                          Control1..1
                                                                          TypeReference(MedComMessagingOrganization)bundled
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                            Summarytrue
                                                                            Requirements

                                                                            Allows routing beyond just the application level.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            98. MessageHeader.destination:cc
                                                                            Slice Namecc
                                                                            Definition

                                                                            The destination application which the message is intended for.

                                                                            ShortMessage destination application(s)
                                                                            Comments

                                                                            There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system.

                                                                            Control0..*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient".

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            100. MessageHeader.destination:cc.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..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            102. MessageHeader.destination:cc.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control1..*
                                                                            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())
                                                                            SlicingThis element introduces a set of slices on MessageHeader.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 104. MessageHeader.destination:cc.extension:use
                                                                              Slice Nameuse
                                                                              Definition

                                                                              Indicates whether the use of a destination in a MedCom message header is as a primary or a carbon copy recipient of the message

                                                                              ShortMedComDestinationUseExtension
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(MedComDestinationUseExtension) (Extension Type: Coding)
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              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())
                                                                              106. MessageHeader.destination:cc.extension:use.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..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              108. MessageHeader.destination:cc.extension:use.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())
                                                                              SlicingThis element introduces a set of slices on MessageHeader.destination.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 110. MessageHeader.destination:cc.extension:use.url
                                                                                Definition

                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                Shortidentifies the meaning of the extension
                                                                                Comments

                                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                Control1..1
                                                                                Typeuri
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                Fixed Valuehttp://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-destinationUseExtension
                                                                                112. MessageHeader.destination:cc.extension:use.value[x]
                                                                                Definition

                                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                ShortValue of extension
                                                                                Control1..1
                                                                                TypeCoding
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                114. MessageHeader.destination:cc.extension:use.value[x].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..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                116. MessageHeader.destination:cc.extension:use.value[x].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.

                                                                                ShortAdditional 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..*
                                                                                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())
                                                                                SlicingThis element introduces a set of slices on MessageHeader.destination.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 118. MessageHeader.destination:cc.extension:use.value[x].system
                                                                                  Definition

                                                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                                                  ShortIdentity of the terminology system
                                                                                  Comments

                                                                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                                  Control1..1
                                                                                  Typeuri
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                                                  Pattern Valuehttp://medcomfhir.dk/ig/terminology/CodeSystem/medcom-messaging-destinationUse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  120. MessageHeader.destination:cc.extension:use.value[x].version
                                                                                  Definition

                                                                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                                  ShortVersion of the system - if relevant
                                                                                  Comments

                                                                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  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()))
                                                                                  122. MessageHeader.destination:cc.extension:use.value[x].code
                                                                                  Definition

                                                                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                                  ShortSymbol in syntax defined by the system
                                                                                  Control1..1
                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Obligations
                                                                                    ObligationsActorSource
                                                                                    SHALL:in-narrativeProducer of FHIR resourcesfrom MedComDestinationUseExtension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to refer to a particular code in the system.

                                                                                    Pattern Valuecc
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    124. MessageHeader.destination:cc.extension:use.value[x].display
                                                                                    Definition

                                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                                    ShortRepresentation defined by the system
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    126. MessageHeader.destination:cc.extension:use.value[x].userSelected
                                                                                    Definition

                                                                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                                    ShortIf this coding was chosen directly by the user
                                                                                    Comments

                                                                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                                    Control0..1
                                                                                    Typeboolean
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                                                    ShortExtensions 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..*
                                                                                    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())
                                                                                    130. MessageHeader.destination:cc.name
                                                                                    Definition

                                                                                    Human-readable name for the target system.

                                                                                    ShortName of system
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    May be used for routing of response and/or to support audit.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    132. MessageHeader.destination:cc.target
                                                                                    Definition

                                                                                    Identifies the target end system in situations where the initial message transmission is to an intermediary system.

                                                                                    ShortParticular delivery destination within the destination
                                                                                    Control0..1
                                                                                    TypeReference(Device)
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Supports multi-hop routing.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    134. MessageHeader.destination:cc.endpoint
                                                                                    Definition

                                                                                    Indicates where the message should be routed to.

                                                                                    ShortActual destination address or id
                                                                                    Comments

                                                                                    The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                                                                                    Control1..1
                                                                                    Typeurl
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:in-narrativeProducer of FHIR resources
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Identifies where to route the message.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      136. MessageHeader.destination:cc.receiver
                                                                                      Definition

                                                                                      Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient.

                                                                                      ShortThe carbon copy reciever of the message. Is only used when a message has multiple recievers.
                                                                                      Control1..1
                                                                                      TypeReference(MedComMessagingOrganization)bundled
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:in-narrativeProducer of FHIR resources
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Allows routing beyond just the application level.

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

                                                                                        Identifies the sending system to allow the use of a trust relationship.

                                                                                        ShortThe actual sender of the message
                                                                                        Comments

                                                                                        Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone.

                                                                                        Control1..1
                                                                                        TypeReference(MedComMessagingOrganization)bundled
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows routing beyond just the application level.

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

                                                                                          The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions.

                                                                                          ShortThe source of the data entry
                                                                                          Comments

                                                                                          Usually only for the request but can be used in a response.

                                                                                          Control0..1
                                                                                          TypeReference(Practitioner, PractitionerRole)
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Need to know for audit/traceback requirements and possibly for authorization.

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

                                                                                          The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions.

                                                                                          ShortThe source of the decision
                                                                                          Comments

                                                                                          Usually only for the request but can be used in a response.

                                                                                          Control0..1
                                                                                          TypeReference(Practitioner, PractitionerRole)
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Need to know for audit/traceback requirements and possibly for authorization.

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

                                                                                          The source application from which this message originated.

                                                                                          ShortContains the information about the target for the Acknowledgement message.
                                                                                          Control1..1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows replies, supports audit.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          146. MessageHeader.source.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..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          148. MessageHeader.source.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.

                                                                                          ShortAdditional 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..*
                                                                                          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())
                                                                                          150. MessageHeader.source.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).

                                                                                          ShortExtensions 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..*
                                                                                          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())
                                                                                          152. MessageHeader.source.name
                                                                                          Definition

                                                                                          Human-readable name for the source system.

                                                                                          ShortName of system
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          May be used to support audit.

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

                                                                                          May include configuration or other information useful in debugging.

                                                                                          ShortName of software running the system
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Supports audit and possibly interface engine behavior.

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

                                                                                          Can convey versions of multiple systems in situations where a message passes through multiple hands.

                                                                                          ShortVersion of software running
                                                                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Supports audit and possibly interface engine behavior.

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

                                                                                          An e-mail, phone, website or other contact point to use to resolve issues with message communications.

                                                                                          ShortHuman contact for problems
                                                                                          Control0..1
                                                                                          TypeContactPoint
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows escalation of technical issues.

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

                                                                                          Identifies the routing target to send acknowledgements to.

                                                                                          ShortActual message source address or id
                                                                                          Comments

                                                                                          The id may be a non-resolvable URI for systems that do not use standard network-based addresses.

                                                                                          Control1..1
                                                                                          Typeurl
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Identifies where to send responses, may influence security permissions.

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

                                                                                            The person or organization that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party.

                                                                                            ShortFinal responsibility for event
                                                                                            Comments

                                                                                            Usually only for the request but can be used in a response.

                                                                                            Control0..1
                                                                                            TypeReference(Practitioner, PractitionerRole, Organization)
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need to know for audit/traceback requirements and possibly for authorization.

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

                                                                                            Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message.

                                                                                            ShortCause of event
                                                                                            Control0..1
                                                                                            BindingFor example codes, see ExampleMessageReasonCodes
                                                                                            (example to http://hl7.org/fhir/ValueSet/message-reason-encounter|4.0.1)

                                                                                            Reason for event occurrence.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization.

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

                                                                                            Information about the message that this message is a response to. Only present if this message is a response.

                                                                                            ShortIf this is a reply to prior message
                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            168. MessageHeader.response.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..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Summaryfalse
                                                                                            170. MessageHeader.response.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.

                                                                                            ShortAdditional 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..*
                                                                                            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())
                                                                                            172. MessageHeader.response.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).

                                                                                            ShortExtensions 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..*
                                                                                            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())
                                                                                            174. MessageHeader.response.identifier
                                                                                            Definition

                                                                                            The MessageHeader.id of the message to which this message is a response.

                                                                                            ShortId of original message
                                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                            Control1..1
                                                                                            Typeid
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows receiver to know what message is being responded to.

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

                                                                                            Code that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not.

                                                                                            Shortok | transient-error | fatal-error
                                                                                            Comments

                                                                                            This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus.

                                                                                            Control1..1
                                                                                            BindingThe codes SHALL be taken from ResponseType
                                                                                            (required to http://hl7.org/fhir/ValueSet/response-code|4.0.1)

                                                                                            The kind of response to a message.

                                                                                            Typecode
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows the sender of the acknowledge message to know if the request was successful or if action is needed.

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

                                                                                            Full details of any issues found in the message.

                                                                                            ShortSpecific list of hints/warnings/errors
                                                                                            Comments

                                                                                            This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error.

                                                                                            Control0..1
                                                                                            TypeReference(OperationOutcome)
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows the sender of the message to determine what the specific issues are.

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

                                                                                            The actual data of the message - a reference to the root/focus class of the event.

                                                                                            ShortThe actual content of the message
                                                                                            Comments

                                                                                            The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets.

                                                                                            Control0..*
                                                                                            TypeReference(Resource)
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources.

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

                                                                                            Permanent link to the MessageDefinition for this message.

                                                                                            ShortLink to the definition for this message
                                                                                            Control0..1
                                                                                            Typecanonical(MessageDefinition)
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows sender to define the expected contents of the message.

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