This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

1.14 R5 Ballot Roadmap

FHIR Infrastructure Work Group

Maturity Level: N/A

Standards Status: Informative

Welcome to the FHIR Release 5 (R5) ballot. The R5 release of FHIR has content labeled with different ballot statuses:

• Normative: Content that is subject to normative ballot rules. Once passed, strict rules are imposed on future change to help ensure inter-version compatibility
• Trial Use: Content that is undergoing FHIR maturity Model based testing. In a future ballot cycle, once sufficiently mature, it will be balloted as normative
• Informative: Content that is advisory (e.g. implementers are not required to conform to the content), or navigational content - tables of contents, generated lists, etc.
• Draft: Content added late in the balloting process that has no formal standing, but is published for visibility. It might not be suitable for use in production systems.
• Deprecated: Content that is in the process of being removed (see deprecation).
• External: Content that is replicated from external standards (e.g. HL7 v2, DICOM) and is not subject to ballot comment. This content is mostly being moved out of the specification now

Note to Implementers: That the entirety of R5 is considered trial-use. Any content introduced as part of R5 is subject to revision after implementation experience. If any new content is labelled as normative, this should be understood to mean that the committees intention is that the content will be normative in R6.

Other new content labelled trial-use may also be candidate material for normative in R6 by the normal rules. Any existing content that was normative in R4 will be subject to normative change rules based on the difference from R4, not R5. R5 is a trial-use version of FHIR.

There are a number of notes requesting input from reviewers as part of this ballot:

• Bundle: Request for ballot comment on potentially breaking changes
• Citation: Call for ballot comments on whether this should exist at all
• CodeSystem: Should some default filters be defined for all code systems?
• R4/R5 differences: These are not updated for the ballot (also R4 Maps
• DocumentManifest: Last call on removing DocumentManifest altogether
• ElementDefinition: Last call on removing XPath from constraints
• Exchange Module: Last call on supporting Protocol-Buffers
• Messaging: Question about reworking reliable messaging to use Bundle.identifier not Bundle.id
• Operations on Large Resources: This needs ballot support or it won't make it into the published standard
• ResearchStudy: Several questions for balloters
• Storage: Is an extension needed
• SupplyRequest: Should this be combined with DeviceRequest?
• SupplyRequest: Request for ballot comments on whether this should merge with DeviceRequest
• ValueSet: Should servers declare their support for implicit valuesets?

1.14.1 The FHIR R5 Ballot Process

This is the full ballot for FHIR R5. No additional ballot is expected, since this is a trial-use ballot.

This ballot introduces many small but significant changes from the previous draft ballot. For a slightly more detailed list, see the version history. Note that there are 3157 change requests applied to R5, of which 1486 changes were considered substantive.

Balloter's attention is drawn to two useful links at the bottom of every page: . These are very useful when preparing ballot comments.

This ballot is using HL7's new Jira balloting process . As such, ballot comments will need to be submitted in Jira and, in general, balloting spreadsheets will not be used. Some organizational and affiliate balloters may continue to use spreadsheets but will be responsible for importing them into Jira themselves and may have slightly different processes for consolidating ballots to take that into account. The ballot desktop will be used for voter registration but will not be available for vote submission. Voters are encouraged to view the recorded tutorial on Jira balloting in addition to reading through the instructions on submitting Jira feedback and using Jira balloting . A webinar will be held part-way through the ballot cycle to provide an opportunity to ask questions about the process. Questions can also be raised on the Jira/Confluence stream on http://chat.fhir.org.

Because this is only an draft ballot, committees are not required to response to comment, but will endeavour to do so.

When submitting your ballot feedback, if you have a general comment on something that you see occurring multiple times, please include at least a couple of specific locations where you see the issue. As much as possible, capture each separate concern as a distinct tracker item ; it makes our job of reconciling much easier. Also, don't forget to fill in the section numbers (gray numbers to the left of each heading) and URLs. Only one URL should be placed in the "url" element or column. If you want to reference additional URLs, include them in the text of your ballot comment.

If you have questions that are interfering with the ability to review the specification or submit ballot comments, please contact one of the co-chairs of the FHIR Management Group: Lloyd McKenzie or David Hay.

Thanks for taking the time to review the FHIR specification. We appreciate any feedback you can provide.

The difference analysis in this ballot for resources is still between Release 3 and Release 4. This will be updated when Release 5 is prior to publication of the final specification. In the meantime, balloters are welcome to comment on suggested improvements to the mappings and difference statements, but these cannot be the basis for negative votes. Contributions may also be made directly (join the conversation at chat.fhir.org ).