Release 4B Snapshot #1

This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Clinical Decision Support Work Group Maturity Level: 0Trial Use Use Context: Any

Definitions for the shareablelibrary Profile.

Library
Element IdLibrary
Definition

The Library resource is a general-purpose container for knowledge asset definitions. It can be used to describe and expose existing knowledge assets such as logic libraries and information model descriptions, as well as to describe a collection of knowledge assets.

Cardinality1..1
Invariants
Inherited by this element
cnl-0WarningName should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
dom-2RuleIf the resource is contained in another resource, it SHALL NOT contain nested Resourcescontained.contained.empty()
dom-3RuleIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resourcecontained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4RuleIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdatedcontained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5RuleIf a resource is contained in another resource, it SHALL NOT have a security labelcontained.meta.security.empty()
dom-6GuidelineA resource should have narrative for robust managementtext.`div`.exists()
This is (only) a best practice guideline because:

When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

Library.id
Element IdLibrary.id
Definition

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

Cardinality0..1
Typeid
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.

Library.meta
Element IdLibrary.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.

Cardinality0..1
TypeMeta
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.implicitRules
Element IdLibrary.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.

Cardinality0..1
Typeuri
Is Modifiertrue (Reason: 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)
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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.language
Element IdLibrary.language
Definition

The base language in which the resource is written.

Cardinality0..1
Terminology BindingIETF language tag
The codes SHOULD be taken from Common Languages
Typecode
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).

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.text
Element IdLibrary.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.

Cardinality0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.contained
Element IdLibrary.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.

Cardinality0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

Library.extension
Element IdLibrary.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.

Cardinality0..*
TypeExtension
Alternate Namesextensions, user content
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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
Library.modifierExtension
Element IdLibrary.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).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them)
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
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.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
Library.url
Element IdLibrary.url
Definition

An absolute URI that is used to identify this library when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this library is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the library is stored on different servers.

Cardinality1..1
Typeuri
Requirements

Allows the library to be referenced by a single globally unique identifier.

Comments

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions .

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.identifier
Element IdLibrary.identifier
Definition

A formal identifier that is used to identify this library when it is represented in other formats, or referenced in a specification, model, design or an instance. e.g. CMS or NQF identifiers for a measure artifact. Note that at least one identifier is required for non-experimental active artifacts.

Cardinality0..*
TypeIdentifier
Must Supporttrue
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this library outside of FHIR, where it is not possible to use the logical URI.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.version
Element IdLibrary.version
Definition

The identifier that is used to identify this version of the library when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the library author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

Cardinality1..1
Typestring
Comments

There may be different library instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the library with the format [url]|[version].

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.name
Element IdLibrary.name
Definition

A natural language name identifying the library. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Cardinality1..1 This element is affected by the following invariants: cnl-0
Typestring
Requirements

Support human navigation and code generation.

Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.title
Element IdLibrary.title
Definition

A short, descriptive, user-friendly title for the library.

Cardinality0..1
Typestring
Must Supporttrue
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.subtitle
Element IdLibrary.subtitle
Definition

An explanatory or alternate title for the library giving additional information about its content.

Cardinality0..1
Typestring
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.status
Element IdLibrary.status
Definition

The status of this library. Enables tracking the life-cycle of the content.

Cardinality1..1
Terminology BindingThe lifecycle status of an artifact.
The codes SHALL be taken from PublicationStatus
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Comments

Allows filtering of libraries that are appropriate for use vs. not.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.experimental
Element IdLibrary.experimental
Definition

A Boolean value to indicate that this library is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Cardinality1..1
Typeboolean
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level library.

Comments

Allows filtering of librarys that are appropriate for use versus not.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.type
Element IdLibrary.type
Definition

Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.

Cardinality1..1
Terminology BindingThe type of knowledge asset this library contains.
The codes SHALL be taken from LibraryType; other codes may be used where these codes are not suitable
TypeCodeableConcept
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.subject[x]
Element IdLibrary.subject[x]
Definition

A code or group definition that describes the intended subject of the contents of the library.

Cardinality0..1
Terminology BindingThe possible types of subjects for a library (E.g. Patient, Practitioner, Organization, Location, etc.).
The codes SHALL be taken from Subject type; other codes may be used where these codes are not suitable
TypeChoice of: CodeableConcept, Reference(Group)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Meaning if MissingPatient
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.date
Element IdLibrary.date
Definition

The date (and optionally time) when the library was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the library changes.

Cardinality0..1
TypedateTime
Must Supporttrue
Alternate NamesRevision Date
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the library. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.publisher
Element IdLibrary.publisher
Definition

The name of the organization or individual that published the library.

Cardinality1..1
Typestring
Requirements

Helps establish the "authority/credibility" of the library. May also allow for contact.

Alternate Namessteward
Comments

Usually an organization but may be an individual. The publisher (or steward) of the library is the organization or individual primarily responsible for the maintenance and upkeep of the library. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the library. This item SHOULD be populated unless the information is available from context.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.contact
Element IdLibrary.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

Cardinality0..*
TypeContactDetail
Must Supporttrue
Comments

May be a web site, an email address, a telephone number, etc.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.description
Element IdLibrary.description
Definition

A free text natural language description of the library from a consumer's perspective.

Cardinality1..1
Typemarkdown
Alternate Namesscope
Comments

This description can be used to capture details such as why the library was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the library as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the library is presumed to be the predominant language in the place the library was created).

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.useContext
Element IdLibrary.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances.

Cardinality0..*
TypeUsageContext
Must Supporttrue
Requirements

Assist in searching for appropriate content.

Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.jurisdiction
Element IdLibrary.jurisdiction
Definition

A legal or geographic region in which the library is intended to be used.

Cardinality0..*
Terminology BindingCountries and regions within which this artifact is targeted for use.
The codes SHALL be taken from Jurisdiction; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Comments

It may be possible for the library to be used in jurisdictions other than those for which it was originally designed or intended.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.purpose
Element IdLibrary.purpose
Definition

Explanation of why this library is needed and why it has been designed as it has.

Cardinality0..1
Typemarkdown
Comments

This element does not describe the usage of the library. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this library.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.usage
Element IdLibrary.usage
Definition

A detailed description of how the library is used from a clinical perspective.

Cardinality0..1
Typestring
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.copyright
Element IdLibrary.copyright
Definition

A copyright statement relating to the library and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the library.

Cardinality0..1
Typemarkdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the library and/or its content.

Alternate NamesLicense, Restrictions
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.approvalDate
Element IdLibrary.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Cardinality0..1
Typedate
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.lastReviewDate
Element IdLibrary.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Cardinality0..1
Typedate
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Comments

If specified, this date follows the original approval date.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.effectivePeriod
Element IdLibrary.effectivePeriod
Definition

The period during which the library content was or is planned to be in active use.

Cardinality0..1
TypePeriod
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the library are or are expected to be used instead.

Comments

The effective period for a library determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.topic
Element IdLibrary.topic
Definition

Descriptive topics related to the content of the library. Topics provide a high-level categorization of the library that can be useful for filtering and searching.

Cardinality0..*
Terminology BindingHigh-level categorization of the definition, used for searching, sorting, and filtering.
For example codes, see DefinitionTopic
TypeCodeableConcept
Requirements

Repositories must be able to determine how to categorize the library so that it can be found by topical searches.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.author
Element IdLibrary.author
Definition

An individiual or organization primarily involved in the creation and maintenance of the content.

Cardinality0..*
TypeContactDetail
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.editor
Element IdLibrary.editor
Definition

An individual or organization primarily responsible for internal coherence of the content.

Cardinality0..*
TypeContactDetail
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.reviewer
Element IdLibrary.reviewer
Definition

An individual or organization primarily responsible for review of some aspect of the content.

Cardinality0..*
TypeContactDetail
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.endorser
Element IdLibrary.endorser
Definition

An individual or organization responsible for officially endorsing the content for use in some setting.

Cardinality0..*
TypeContactDetail
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.relatedArtifact
Element IdLibrary.relatedArtifact
Definition

Related artifacts such as additional documentation, justification, or bibliographic references.

Cardinality0..*
TypeRelatedArtifact
Requirements

Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.parameter
Element IdLibrary.parameter
Definition

The parameter element defines parameters used by the library.

Cardinality0..*
TypeParameterDefinition
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.dataRequirement
Element IdLibrary.dataRequirement
Definition

Describes a set of data that must be provided in order to be able to successfully perform the computations defined by the library.

Cardinality0..*
TypeDataRequirement
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Library.content
Element IdLibrary.content
Definition

The content of the library as an Attachment. The content may be a reference to a url, or may be directly embedded as a base-64 string. Either way, the contentType of the attachment determines how to interpret the content.

Cardinality0..*
TypeAttachment
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())