2025.2.0 - ci-build

IGTTPFHIRGatewaygICS - Local Development build (v2025.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ExchangeFormatDefinition - Detailed Descriptions

Draft as of 2025-06-12

Definitions for the ExchangeFormatDefinition resource profile.

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

0. Bundle
Definition

A container for a collection of resources.

ShortContains a collection of resources
Control0..*
Invariantsbdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct())
bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited (entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history')))
bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited (entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history')))
bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
bdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset'))
bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
2. Bundle.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
This element is affected by the following invariants: ele-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()))
4. Bundle.type
Definition

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

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

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

Control1..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from BundleTypehttp://hl7.org/fhir/ValueSet/bundle-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

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

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valuecollection
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Bundle.type.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..*
This element is affected by the following invariants: ele-1
TypeExtension
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 Bundle.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Bundle.type.extension:supportedVersion
    Slice NamesupportedVersion
    Definition

    Format von Versionsangaben für Module

    ShortFormat von Modulversionsangaben
    Comments

    Werden sowohl formatString als auch formatExpression angegeben, müssen diese synonym sein.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(SupportedVersion) (Extension Type: string)
    Must Supporttrue
    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())
    10. Bundle.type.extension:supportedVersion.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*
    This element is affected by the following invariants: ele-1
    TypeExtension
    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 Bundle.type.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 12. Bundle.type.extension:supportedVersion.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
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttps://ths-greifswald.de/fhir/StructureDefinition/gics/SupportedVersion
      14. Bundle.type.extension:supportedVersion.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
      This element is affected by the following invariants: ele-1
      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, 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]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Bundle.total
      Definition

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

      ShortIf search, the total number of matches
      Comments

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

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

      A series of links that provide context to this bundle.

      ShortLinks related to this Bundle
      Comments

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

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

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

      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      23. Bundle.entry
      Definition

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

      ShortEntry in the bundle - will have a resource or information
      Control10..*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
      bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
      25. Bundle.entry.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..*
      This element is affected by the following invariants: ele-1
      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())
      27. Bundle.entry.link
      Definition

      A series of links that provide context to this entry.

      ShortLinks related to this entry
      Control0..0*
      TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
      Summarytrue
      29. Bundle.entry.resource
      Definition

      Atomare Aussage zu der eine Person seine Einwilligung erteilen kann


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

      ShortConsent PolicyA resource in the bundle
      Control10..1
      TypeChoice of: ActivityDefinition(ConsentPolicy), Questionnaire(Consent Module, Consent Template, Consent Management Questionnaire Composed), ResearchStudy(Consent Domain), Resource
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      31. Bundle.entry.search
      Definition

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

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

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

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

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

      ShortResults of execution (transaction/batch/history)
      Control0..01
      This element is affected by the following invariants: ele-1, bdl-4
      TypeBackboneElement
      Summarytrue
      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. Bundle
      2. Bundle.type
      Must Supporttrue
      Fixed Valuecollection
      4. Bundle.type.extension
      Control1..?
      6. Bundle.type.extension:supportedVersion
      Slice NamesupportedVersion
      Control1..1
      TypeExtension(SupportedVersion) (Extension Type: string)
      Must Supporttrue
      8. Bundle.type.extension:supportedVersion.value[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      10. Bundle.total
      Control0..0
      12. Bundle.link
      Control0..0
      14. Bundle.entry
      Control1..?
      Must Supporttrue
      16. Bundle.entry.link
      Control0..0
      18. Bundle.entry.resource
      Control1..?
      TypeChoice of: ActivityDefinition(ConsentPolicy), Questionnaire(Consent Module, Consent Template, Consent Management Questionnaire Composed), ResearchStudy(Consent Domain), Resource
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      20. Bundle.entry.search
      Control0..0
      22. Bundle.entry.request
      Control0..0
      24. Bundle.entry.response
      Control0..0

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

      0. Bundle
      Definition

      A container for a collection of resources.

      ShortContains a collection of resources
      Control0..*
      Invariantsbdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct())
      bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
      bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited (entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history')))
      bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited (entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history')))
      bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
      bdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
      bdl-2: entry.search only when a search (entry.search.empty() or (type = 'searchset'))
      bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
      bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
      2. Bundle.id
      Definition

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

      ShortLogical 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.

      Control0..1
      Typeid
      Summarytrue
      4. Bundle.meta
      Definition

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

      ShortMetadata about the resource
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeMeta
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Bundle.implicitRules
      Definition

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

      ShortA set of rules under which this content was created
      Comments

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

      Control0..1
      This element is affected by the following invariants: ele-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. Bundle.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

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

      Control0..1
      This element is affected by the following invariants: ele-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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Bundle.identifier
      Definition

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

      ShortPersistent identifier for the bundle
      Comments

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

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeIdentifier
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Bundle.type
      Definition

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

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

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

      Control1..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from BundleType
      (required to http://hl7.org/fhir/ValueSet/bundle-type|4.0.1)

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

      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Fixed Valuecollection
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Bundle.type.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
      XML FormatIn the XML format, this property is represented as an attribute.
      16. Bundle.type.extension
      Definition

      An Extension

      ShortExtension
      Control1..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      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 Bundle.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 18. Bundle.type.extension:supportedVersion
        Slice NamesupportedVersion
        Definition

        Format von Versionsangaben für Module

        ShortFormat von Modulversionsangaben
        Comments

        Werden sowohl formatString als auch formatExpression angegeben, müssen diese synonym sein.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(SupportedVersion) (Extension Type: string)
        Must Supporttrue
        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())
        20. Bundle.type.extension:supportedVersion.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
        XML FormatIn the XML format, this property is represented as an attribute.
        22. Bundle.type.extension:supportedVersion.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        This element is affected by the following invariants: ele-1
        TypeExtension
        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 Bundle.type.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 24. Bundle.type.extension:supportedVersion.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
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttps://ths-greifswald.de/fhir/StructureDefinition/gics/SupportedVersion
          26. Bundle.type.extension:supportedVersion.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
          This element is affected by the following invariants: ele-1
          Typestring
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Bundle.type.value
          Definition

          Primitive value for code

          ShortPrimitive value for code
          Control0..1
          Typecode
          XML FormatIn the XML format, this property is represented as an attribute.
          Max Length:1048576
          30. Bundle.timestamp
          Definition

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

          ShortWhen the bundle was assembled
          Comments

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

          Usage:

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

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

          Control0..1
          This element is affected by the following invariants: ele-1
          Typeinstant
          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()))
          32. Bundle.total
          Definition

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

          ShortIf search, the total number of matches
          Comments

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

          Control0..0
          This element is affected by the following invariants: ele-1, bdl-1
          TypeunsignedInt
          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()))
          34. Bundle.link
          Definition

          A series of links that provide context to this bundle.

          ShortLinks related to this Bundle
          Comments

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

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

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

          Control0..0
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          41. Bundle.entry
          Definition

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

          ShortEntry in the bundle - will have a resource or information
          Control1..*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          bdl-8: fullUrl cannot be a version specific reference (fullUrl.contains('/_history/').not())
          bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
          43. Bundle.entry.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
          XML FormatIn the XML format, this property is represented as an attribute.
          45. Bundle.entry.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..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Standard StatusNormative (from Normative)
          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 Bundle.entry.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 47. Bundle.entry.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..*
            This element is affected by the following invariants: ele-1
            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())
            49. Bundle.entry.link
            Definition

            A series of links that provide context to this entry.

            ShortLinks related to this entry
            Control0..0
            TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
            Summarytrue
            51. Bundle.entry.fullUrl
            Definition

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

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

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            Typeuri
            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()))
            53. Bundle.entry.resource
            Definition

            Atomare Aussage zu der eine Person seine Einwilligung erteilen kann

            ShortConsent Policy
            Control1..1
            TypeChoice of: ActivityDefinition(ConsentPolicy), Questionnaire(Consent Module, Consent Template, Consent Management Questionnaire Composed), ResearchStudy(Consent Domain)
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            55. Bundle.entry.search
            Definition

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

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

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

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

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

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

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

            ShortDigital Signature
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeSignature
            Summarytrue
            Requirements

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

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