Release 5 Preview #3


FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Patient, Practitioner

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Fetch a group of Patient Records

OPERATION: Fetch a group of Patient Records

The official URL for this operation definition is:

This operation is used to return all the information related to one or more patients that are part of the group on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the patient resource(s) itself is returned, along with any other resources that the server has that are related to the patient(s), and that are available for the given user. The server also returns whatever resources are needed to support the records - e.g. linked practitioners, medications, locations, organizations etc. The intended use for this operation is for a provider or other user to perform a bulk data download. The server SHOULD return at least all resources that it has that are in the patient compartment for the identified patient(s), and any resource referenced from those, including binaries and attachments. In the US Realm, at a mimimum, the resources returned SHALL include all the data covered by the meaningful use common data elements as defined in US-Core. Other applicable implementation guides may make additional rules about how much information that is returned.

URL: [base]/Group/[id]/$everything



The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no start date is provided, all records prior to the end date are in scope.


The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no end date is provided, all records subsequent to the start date are in scope.


Resources updated after this period will be included in the response. The intent of this parameter is to allow a client to request only records that have changed since the last request, based on either the return header time, or or (for asynchronous use), the transaction time


One or more parameters, each containing one or more comma-delimited FHIR resource types to include in the return resources. In the absense of any specified types, the server returns all resource types


See discussion below on the utility of paging through the results of the $everything operation


The bundle type is "searchset"

The key differences between this operation and simply searching the group's patients compartment are:

  • unless the client requests otherwise, the server returns the entire result set in a single bundle (rather than using paging)
  • the server is responsible for determining what resources to return as included resources (rather than the client specifying which ones).

This frees the client from needing to determine what it could or should ask for, particularly with regard to included resources.

It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a particular group, or determine whether the context has the rights to the nominated group, if there is one, or can determine an appropriate list of groups to provide data for from the context of the request. If there is no nominated group (GET /Group/$everything) and the context is not associated with a single group record, the actual list of groups is all groups that the user associated with the request has access to. In such cases, the server may choose to return an error rather than all the records (and is likely to do so, but not required to). Specifying the relationship between the context, a user and groups is outside the scope of this specification (though see The Smart App Launch Implementation Guide.

The return bundle from this operation is usually rather a lot of data; servers typically choose to require that such requests are made asynchronously, and associated with bulk data formats. Alternatively, clients may choose to page through the result set (or servers may require this). Paging through the results is done the same as for Searching, using the _count parameter, and Bundle links. Implementers should note that paging will be slower than simply returning all the results at once (more network traffic, multiple latency delays) but may be required in order not to exhaust available memory reading or writing the whole response in a single package. Unlike searching, there is no inherent user-display order for the $everything operation. Servers might consider sorting the returned resources in descending order of last record update, but are not required to do so.

The _since parameter is provided to support periodic queries to get additional information that has changed about the group since the last query. This means that the _since parameter is based on record time. The value of the _since parameter should be set to the time from the server. If using direct response, this is the timestamp in the response header. If using the async interface, this is the transaction timestamp in the json response. Servers should ensure that the timestamps a managed such that the client does not miss any changes. Clients should be able to handle getting the same response more than once in the case that the transaction falls on a time boundary. Clients should ensure that the other query parameters are constant to ensure a coherent set of records when doing periodic queries.



Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.