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1.2 Patterns Index

FHIR Infrastructure icon Work GroupMaturity Level: N/AStandards Status: Informative

Types Framework Cross Reference: Base Types | Datatypes | Resources | Patterns

This specification defines 161 Resources as the primary means for exchange for data. In addition, this specification defines a number of patterns to assist implementers to better understand the relationships between the resources, and also to support the use of abstractions of the resources when implementing common tasks.

There are two different types of patterns:

  • Design Patterns: General patterns that resources may follow to some degree, depending on the requirements of the domain that they represent
  • Interface Patterns: Specific patterns that are intended to be used as operation abstractions for the resources that follow (=implement) them

Design Patterns

These patterns provide general guidelines around the design of the resources that follow them. The resources that follow these patterns indicate how they follow the pattern by mapping elements in the resource to the pattern. In general, resources may:

  • have a matching element, or not (or define an extension for the element)
  • split different possible values between different elements
  • use different types, or codes that have different values
  • have different cardinalities, based on domain analysis

The following Design Patterns are defined:

Interface Patterns

These patterns are intended to provide abstractions for the resources that follow them, for use by implementers. The resources that follow these patterns indicate how they follow the pattern by mapping elements in the resource to the pattern. These patterns are followed more closely, and resources may:

  • use a different name for the element
  • allow for a higher cardinality that the pattern
  • provide a concept map to map between values in the resource and the element values e.g. mapping a set of status codes to an active : boolean
  • use a different type with a defined conversion to the pattern type

The following Interface Patterns are defined:

Pattern Candidates

Patterns are a work in progress. This analysis helps identify candidate patterns:

Participation type Patterns

Resources Pattern (or candidates) Locations
ActivityDefinition, BiologicallyDerivedProduct, DeviceDefinition, Ingredient, Location, ManufacturedItemDefinition, MedicinalProductDefinition, NutritionProduct, ObservationDefinition, Organization, PackagedProductDefinition, PlanDefinition, Practitioner, ResearchStudy, SubstanceDefinition RegulatedAuthorization.subject
BiologicallyDerivedProduct, Device, Group, Location, Medication, NutritionProduct, Organization, Patient, Practitioner, Procedure, Substance DetectedIssue.subject
Observation.subject
BiologicallyDerivedProduct, Device, Group, Location, Medication, Organization, Patient, Practitioner, Substance DiagnosticReport.subject
BiologicallyDerivedProduct, Device, Group, Location, Patient, Substance Specimen.subject
BiologicallyDerivedProduct, Device, Group, Medication, Patient, Specimen, Substance ResearchSubject.subject
BiologicallyDerivedProduct, Group, NutritionProduct, Patient, Substance GenomicStudy.subject
CareTeam, Device, DeviceDefinition, Endpoint, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant + [Endpoint, DeviceDefinition] ActivityDefinition.participant.typeReference
PlanDefinition.actor.option.typeReference
PlanDefinition.action.participant.typeReference
RequestOrchestration.action.participant.typeReference
CareTeam, Device, Endpoint, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant + [Endpoint] Communication.recipient
CareTeam, Device, Endpoint, Group, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant + [Endpoint] - [Location] CommunicationRequest.recipient
CareTeam, Device, Endpoint, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant + [Endpoint] - [Group, Location] Communication.sender
CareTeam, Device, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant MeasureReport.subject
MeasureReport.group.subject
RequestOrchestration.subject
CareTeam, Device, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Specimen Participant + [Specimen] Group.member.entity
CareTeam, Device, Group, HealthcareService, Location, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Organization] Appointment.participant.actor
CareTeam, Device, Group, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Location] Requirements.statement.source
CareTeam, Device, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [HealthcareService, Location] Consent.provision.actor.reference
NutritionIntake.performer.actor
Permission.rule.activity.actor
Provenance.agent.who
CareTeam, Device, HealthcareService, Location, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Group, Organization] Schedule.actor
CareTeam, Device, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Group, Location] ChargeItem.performer.actor
ImagingSelection.performer.actor
ImagingStudy.series.performer.actor
Procedure.performer.actor
ServiceRequest.performer
Transport.owner
CareTeam, Device, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Substance Participant + [Substance] - [Group, HealthcareService] Contract.term.action.performer
CareTeam, Device, Organization, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Group, HealthcareService, Location] Task.performer.actor
CareTeam, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Group, HealthcareService, Location] AdverseEvent.participant.actor
AuditEvent.agent.who
AuditEvent.source.observer
Basic.author
CarePlan.custodian
CarePlan.contributor
DeviceDispense.performer.actor
DocumentReference.author
FamilyMemberHistory.participant.actor
List.source
MedicationDispense.performer.actor
SupplyRequest.requester
CareTeam, DeviceDefinition, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson MedicationRequest.performer
CareTeam, Group, Organization, Patient, Practitioner, PractitionerRole Provenance.agent.onBehalfOf
CareTeam, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Specimen Procedure.focus
CareTeam, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Group, Device, Location] Consent.grantor
Consent.grantee
Permission.asserter
Subscription.managingEntity
CareTeam, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [CareTeam, PractitionerRole] - [Location]
ParticipantLiving + [Organization, CareTeam, PractitionerRole]
CareTeam.participant.member
CareTeam.participant.onBehalfOf
Goal.acceptance.participant
Observation.performer
Task.owner
CareTeam, Organization, Practitioner, PractitionerRole DiagnosticReport.performer
DiagnosticReport.resultsInterpreter
CareTeam, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantLiving + [CareTeam, PractitionerRole] Goal.source
Device, Endpoint, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson CommunicationRequest.informationProvider
Device, Group, HealthcareService, Location, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Organization, CareTeam] AppointmentResponse.actor
Device, Group, HealthcareService, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [Organization, CareTeam, Location] Encounter.participant.actor
Device, Group, Location, Organization, Patient, Practitioner ParticipantContactable + [Group, Device] - [RelatedPerson] Procedure.subject
Device, Group, Location, Patient DeviceRequest.subject
ServiceRequest.subject
Device, Group, Medication, Patient, Practitioner, Procedure, Specimen, Substance ImagingSelection.subject
Device, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson Participant - [CareTeam, HealthcareService, Location] Contract.term.offer.party.reference
Contract.term.action.subject.reference
Contract.term.action.requester
EvidenceReport.section.author
Device, Group, Patient ImagingStudy.subject
Device, Group, Patient, Practitioner, RelatedPerson ParticipantLiving + [Group, Device] DeviceAssociation.subject
Device, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole Participant - [Group, CareTeam, RelatedPerson] Account.subject
Device, Organization, Patient, Practitioner, PractitionerRole ArtifactAssessment.content.author
MessageHeader.source.sender
Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [Device, PractitionerRole] - [Location]
ParticipantLiving + [Organization, Device, PractitionerRole]
Signature.who
Signature.onBehalfOf
ChargeItem.enterer
CommunicationRequest.requester
Composition.author
Composition.section.author
Flag.author
Invoice.participant.actor
MedicationRequest.requester
MedicationStatement.informationSource
MessageHeader.destination.receiver
QuestionnaireResponse.author
QuestionnaireResponse.source
ServiceRequest.requester
Task.requester
Transport.requester
Device, Organization, Practitioner, PractitionerRole DeviceRequest.requester
GenomicStudy.analysis.performer.actor
Device, Patient ParticipantLiving + [Device] - [Practitioner, RelatedPerson] DeviceAlert.subject
Device, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantLiving + [Device, PractitionerRole] Condition.asserter
DetectedIssue.author
RiskAssessment.performer
Device, Patient, Practitioner, RelatedPerson ParticipantContactable + [Device] - [Organization, Location]
ParticipantLiving + [Device]
InventoryReport.reporter
Device, Practitioner, PractitionerRole RequestOrchestration.author
Group, Location, Medication, Organization, Patient, PlanDefinition, Practitioner, PractitionerRole, Procedure, RelatedPerson Flag.subject
Group, Organization, Patient Goal.subject
Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [Group, PractitionerRole] - [Location]
ParticipantLiving + [Group, Organization, PractitionerRole]
Task.restriction.recipient
Transport.restriction.recipient
Group, Organization, Practitioner, PractitionerRole MeasureReport.reporter
Group, Patient ParticipantLiving + [Group] - [Practitioner, RelatedPerson] Appointment.subject
CarePlan.subject
CareTeam.subject
ChargeItem.subject
ClinicalImpression.subject
Communication.subject
CommunicationRequest.subject
Condition.subject
Encounter.subject
EncounterHistory.subject
EpisodeOfCare.subject
GuidanceResponse.subject
Invoice.subject
MedicationAdministration.subject
MedicationDispense.subject
MedicationRequest.subject
MedicationStatement.subject
NutritionIntake.subject
NutritionOrder.subject
RiskAssessment.subject
Group, Patient, Practitioner, RelatedPerson ParticipantContactable + [Group] - [Organization, Location]
ParticipantLiving + [Group]
AdverseEvent.subject
Group, Patient, Practitioner, ResearchSubject ParticipantLiving + [Group, ResearchSubject] - [RelatedPerson] Consent.subject
HealthcareService, Organization SupplyRequest.supplier
HealthcareService, Organization, Patient, Practitioner ParticipantContactable + [HealthcareService] - [RelatedPerson, Location]
ParticipantLiving + [Organization, HealthcareService] - [RelatedPerson]
Consent.manager
Consent.controller
Location, Organization ParticipantContactable - [Practitioner, Patient, RelatedPerson] Claim.facility
CoverageEligibilityRequest.item.facility
Encounter.admission.origin
Encounter.admission.destination
ExplanationOfBenefit.facility
SupplyRequest.deliverFrom
Location, Organization, Patient, RelatedPerson ParticipantContactable - [Practitioner]
ParticipantLiving + [Organization, Location] - [Practitioner]
SupplyRequest.deliverTo
Location, Organization, Practitioner, PractitionerRole ParticipantContactable + [PractitionerRole] - [Patient, RelatedPerson] SupplyDelivery.destination
Location, Organization, ResearchStudy ResearchStudy.site
Location, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [PractitionerRole] - [Organization]
ParticipantLiving + [PractitionerRole, Location]
DeviceDispense.receiver
MedicationDispense.receiver
Organization, Patient ParticipantContactable - [Practitioner, RelatedPerson, Location]
ParticipantLiving + [Organization] - [Practitioner, RelatedPerson]
BiologicallyDerivedProduct.collection.source
InventoryItem.instance.subject
Organization, Patient, Practitioner, PractitionerRole ParticipantContactable + [PractitionerRole] - [RelatedPerson, Location]
ParticipantLiving + [Organization, PractitionerRole] - [RelatedPerson]
Contract.author
Organization, Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [PractitionerRole] - [Location]
ParticipantLiving + [Organization, PractitionerRole]
Annotation.author[x]
AllergyIntolerance.recorder
Claim.payee.party
Composition.attester.party
Contract.term.asset.valuedItem.responsible
Contract.term.asset.valuedItem.recipient
Contract.signer.party
DeviceUsage.informationSource
DocumentReference.attester.party
ExplanationOfBenefit.payee.party
Immunization.performer.actor
MedicationRequest.informationSource
Specimen.collection.collector
Organization, Patient, Practitioner, RelatedPerson ParticipantContactable - [Location]
ParticipantLiving + [Organization]
PersonalRelationship.asserter
Organization, Patient, RelatedPerson ParticipantContactable - [Practitioner, Location]
ParticipantLiving + [Organization] - [Practitioner]
Account.guarantor.party
Coverage.paymentBy.party
Coverage.policyHolder
Invoice.recipient
PaymentReconciliation.paymentIssuer
Organization, Practitioner ParticipantContactable - [Patient, RelatedPerson, Location]
ParticipantLiving + [Organization] - [Patient, RelatedPerson]
Citation.citedArtifact.contributorship.entry.contributor
Organization, Practitioner, PractitionerRole Claim.provider
Claim.careTeam.provider
ClaimResponse.requestor
ClaimResponse.addItem.provider
Consent.verification.verifiedBy
Contract.contentDefinition.publisher
CoverageEligibilityRequest.provider
CoverageEligibilityResponse.requestor
EnrollmentRequest.provider
EnrollmentResponse.requestProvider
ExplanationOfBenefit.provider
ExplanationOfBenefit.careTeam.provider
ExplanationOfBenefit.addItem.provider
Linkage.author
MedicationDispense.substitution.responsibleParty
Patient.generalPractitioner
PaymentNotice.reporter
PaymentNotice.payee
PaymentReconciliation.enterer
PaymentReconciliation.requestor
PaymentReconciliation.allocation.submitter
PaymentReconciliation.allocation.payee
ResearchStudy.associatedParty.party
SupplyDelivery.supplier
SupplyDelivery.receiver
VerificationResult.primarySource.who
VerificationResult.attestation.who
VerificationResult.attestation.onBehalfOf
Organization, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [PractitionerRole] - [Patient, Location]
ParticipantLiving + [Organization, PractitionerRole] - [Patient]
Group.managingEntity
Organization, PractitionerRole Citation.citedArtifact.contributorship.entry.affiliation
MedicinalProductDefinition.contact.contact
Patient, Person, Practitioner, RelatedPerson ParticipantContactable + [Person] - [Organization, Location]
ParticipantLiving + [Person]
Person.link.target
Patient, Person, RelatedPerson ParticipantLiving + [Person] - [Practitioner] PersonalRelationship.source
PersonalRelationship.target
Patient, Practitioner ParticipantContactable - [Organization, RelatedPerson, Location]
ParticipantLiving - [RelatedPerson]
DeviceDispense.subject
Patient, Practitioner, PractitionerRole, RelatedPerson ParticipantContactable + [PractitionerRole] - [Organization, Location]
ParticipantLiving + [PractitionerRole]
AdverseEvent.recorder
AdverseEvent.suspectEntity.causality.author
AllergyIntolerance.asserter
Claim.enterer
Condition.recorder
ExplanationOfBenefit.enterer
Procedure.recorder
Specimen.processing.performer
Patient, Practitioner, RelatedPerson ParticipantLiving DeviceAssociation.operation.operator
Patient, RelatedPerson ParticipantContactable - [Practitioner, Organization, Location]
ParticipantLiving - [Practitioner]
Consent.verification.verifiedWith
Coverage.subscriber
Patient.link.other
Practitioner, PractitionerRole ParticipantLiving + [PractitionerRole] - [Patient, RelatedPerson] BiologicallyDerivedProduct.collection.collector
ClinicalImpression.performer
CoverageEligibilityRequest.enterer
CoverageEligibilityRequest.item.provider
CoverageEligibilityResponse.insurance.item.provider
DetectedIssue.mitigation.author
EpisodeOfCare.careManager
GenomicStudy.referrer
GenomicStudy.interpreter
ImagingStudy.referrer
MedicationRequest.recorder
NutritionOrder.orderer
VisionPrescription.prescriber

Other Patterns

Resources Pattern (or candidates) Locations
Account, ChargeItem, Claim, Contract, Encounter, Invoice PaymentReconciliation.allocation.target
ActivityDefinition, BiologicallyDerivedProduct, Device, DeviceDefinition, Medication, MedicinalProductDefinition, NutritionProduct, PlanDefinition, Substance ClinicalUseDefinition.subject
ActivityDefinition, Device, DeviceDefinition, HealthcareService, Medication, PlanDefinition, Substance ChargeItemDefinition.instance
AdministrableProductDefinition, ManufacturedItemDefinition, MedicinalProductDefinition Ingredient.for
AllergyIntolerance, Citation, DeviceUsage, DiagnosticReport, FamilyMemberHistory, ImagingStudy, Observation, Procedure DiagnosticReport.supportingInfo.reference
AllergyIntolerance, Condition ClinicalImpression.problem
AllergyIntolerance, Condition, Observation, Procedure, RiskAssessment Flag.supportingInfo
Appointment, AppointmentResponse, CarePlan, Claim, CommunicationRequest, Contract, CoverageEligibilityRequest, DeviceRequest, EnrollmentRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest, SupplyRequest, Task, VisionPrescription Request + [AppointmentResponse, Contract] - [Transport] GuidanceResponse.result
Appointment, AppointmentResponse, CarePlan, Claim, CommunicationRequest, Contract, CoverageEligibilityRequest, DeviceRequest, EnrollmentRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest, SupplyRequest, VisionPrescription DocumentReference.basedOn
Appointment, AppointmentResponse, CarePlan, ServiceRequest, Task ImagingSelection.basedOn
ImagingStudy.basedOn
Appointment, CommunicationRequest, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest, SupplyRequest, Task, VisionPrescription CarePlan.activity.plannedActivityReference
Appointment, Encounter, EpisodeOfCare DocumentReference.context
BiologicallyDerivedProduct, Device, DeviceDefinition, InventoryItem, Medication, MedicationKnowledge, NutritionProduct InventoryItem.association.relatedItem
BiologicallyDerivedProduct, Device, Medication, NutritionProduct InventoryItem.productReference
BiologicallyDerivedProduct, Medication, MedicinalProductDefinition, NutritionProduct, ObservationDefinition, Substance ClinicalUseDefinition.interaction.interactant.item[x]
CarePlan, CommunicationRequest, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest, Task, VisionPrescription Communication.basedOn
CarePlan, DeviceRequest DeviceDispense.basedOn
CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest, VisionPrescription Appointment.basedOn
Encounter.basedOn
CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest Observation.basedOn
CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest DiagnosticReport.basedOn
CarePlan, ImmunizationRecommendation, MedicationRequest, RequestOrchestration, ServiceRequest MedicationRequest.basedOn
CarePlan, ImmunizationRecommendation, MedicationRequest, ServiceRequest Immunization.basedOn
CarePlan, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest ServiceRequest.basedOn
CarePlan, MedicationRequest, ServiceRequest Procedure.basedOn
CarePlan, NutritionOrder, RequestOrchestration, ServiceRequest CarePlan.basedOn
NutritionOrder.basedOn
VisionPrescription.basedOn
CarePlan, NutritionOrder, ServiceRequest NutritionIntake.basedOn
CarePlan, ServiceRequest QuestionnaireResponse.basedOn
Citation, Composition, DiagnosticReport ResearchStudy.result
Claim, DocumentReference, Observation, Procedure, QuestionnaireResponse, ServiceRequest DeviceUsage.derivedFrom
ClaimResponse, Coverage DeviceRequest.insurance
MedicationRequest.insurance
ServiceRequest.insurance
Task.insurance
Transport.insurance
ClinicalImpression, DiagnosticReport, Observation Condition.stage.assessment
Composition, DiagnosticReport, DocumentReference Procedure.report
Condition, MedicationRequest, MedicationStatement, NutritionIntake, NutritionOrder, Observation, Procedure, RiskAssessment, ServiceRequest Goal.addresses
Condition, Observation AdverseEvent.resultingEffect
MedicationStatement.relatedClinicalInformation
Consent, Contract, DocumentReference, QuestionnaireResponse Consent.sourceReference
Contract, SupplyDelivery SupplyDelivery.partOf
Device, DeviceDefinition ObservationDefinition.device
Device, DeviceDefinition, DeviceMetric Group.characteristic.determinedBy[x]
Device, DeviceMetric DeviceAlert.source
Observation.device
DeviceDefinition, ManufacturedItemDefinition MedicinalProductDefinition.comprisedOf
DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription Claim.item.request
ClaimResponse.addItem.request
ExplanationOfBenefit.item.request
ExplanationOfBenefit.addItem.request
DeviceRequest, MedicationRequest, RequestOrchestration, ServiceRequest, SupplyRequest, Task, VisionPrescription Transport.basedOn
DeviceRequest, MedicationRequest, VisionPrescription Claim.prescription
Claim.originalPrescription
DocumentReference, GenomicStudy, ImagingSelection, ImagingStudy, MolecularSequence, Observation, QuestionnaireResponse Observation.derivedFrom
DocumentReference, ImagingStudy ImagingSelection.derivedFrom
DocumentReference, Observation GenomicStudy.analysis.regionsStudied
GenomicStudy.analysis.regionsCalled
Encounter, EpisodeOfCare Account.covers
Contract.term.action.context
DeviceUsage.context
EvidenceVariable, Group Evidence.variableDefinition.observed
Evidence.variableDefinition.intended
Evidence.statistic.modelCharacteristic.variable.variableDefinition
ResearchStudy.recruitment.eligibility
GenomicStudy, ImagingStudy DiagnosticReport.study
GenomicStudy, ImagingStudy, Immunization, MedicationAdministration, MedicationDispense, MedicationStatement, Procedure Observation.partOf
Group, Specimen Observation.specimen
Immunization, ImmunizationEvaluation ImmunizationRecommendation.recommendation.supportingImmunization
Ingredient, Medication, Substance, SubstanceDefinition ActivityDefinition.product[x]
MedicationAdministration, MedicationDispense, Procedure MedicationAdministration.partOf
MedicationAdministration, Observation, Procedure Procedure.partOf
MedicationAdministration, Procedure MedicationDispense.partOf
MedicationRequest, VisionPrescription ExplanationOfBenefit.prescription
MedicationStatement, Procedure MedicationStatement.partOf
MolecularSequence, Observation, QuestionnaireResponse Observation.hasMember
NutritionIntake, Observation, Procedure NutritionIntake.partOf
Observation, Procedure QuestionnaireResponse.partOf
ObservationDefinition, Questionnaire ObservationDefinition.hasMember
Procedure, Task GenomicStudy.analysis.protocolPerformed
ServiceRequest, Task GenomicStudy.basedOn