Usage

The bundle MUST contain exactly one Patient resource conforming to the CancerPatient profile. The bundle MUST also contain following mCODE-conformant resources, if available to the server:

• Condition resources representing the PrimaryCancerCondition and SecondaryCancerCondition, if applicable
• Observation resources representing CancerDiseaseStatus
• Observation resources representing ECOGPerformanceStatus and/or KarnofskyPerformanceStatus
• Observation resources representing any TumorMarkerTest
• MedicationRequest resources conforming to CancerRelatedMedicationRequest and CancerRelatedMedicationAdministration, representing any cancer-related prescriptions, administrations, and patient-reported medications
• Procedure resources representing any CancerRelatedSurgicalProcedure and RadiotherapyCourseSummary
• Observation resources representing the staging information: CancerStageGroup, TNMDistantMetastasesCategory, TNMPrimaryTumorCategory, and TNMRegionalNodesCategory
• Observation resources representing GenomicVariant and GenomicRegionStudied
• DiagnosticReport resources representing GenomicsReport
• Specimen resources representing to GenomicSpecimen and TumorSpecimen
• BodyStructure resources representing Tumor
• Observation resources representing TumorSize
• Observation resource representing to ComorbiditiesElixhauser, and any referenced Condition resources
• Observation resources for patient height, weight, blood pressure
• Laboratory results from Comprehensive Metabolic Panels (CMP) and Complete Blood Counts (CBC)

In addition, the bundle MAY contain additional resources relevant to the patient but not part of mCODE, such as smoking status, family member history, and diagnostic procedures.

By default, this Bundle includes all required resources described above, irrespective of care dates associated with the resources. For some types of resources, such as vital signs, a very large number of resources will therefore be included by default. To limit the number of included resources, callers MAY specify start and end parameters when requesting a patient’s mCODE bundle via the Sender’s FHIR API, which operate in the same way as for the Fetch Patient Record operation.

Conformance

The bundle itself MUST validate against the current profile.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints
Bundle		0..*	Bundle	Contains a collection of resources
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Required Pattern: collection
timestamp	S	0..1	instant	When the bundle was assembled
Slices for entry	S	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource
entry:All Slices				Content/Rules for all slices
resource	S	1..1	Resource	A resource in the bundle
entry:cancerPatient	S	1..1	BackboneElement	Cancer Patient
resource		0..1	CancerPatient	Information about an individual or animal receiving health care services
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: collection
timestamp	SΣ	0..1	instant	When the bundle was assembled
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	SΣ	1..1	Resource	A resource in the bundle
entry:cancerPatient	SΣC	1..1	BackboneElement	Cancer Patient This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	S	0..1	CancerPatient	Information about an individual or animal receiving health care services
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.type	required	Pattern: collection

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose ​AllLanguages Max Binding
identifier	Σ	0..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: collection
timestamp	SΣ	0..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:cancerPatient	SΣC	1..1	BackboneElement	Cancer Patient This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	0..1	CancerPatient	Information about an individual or animal receiving health care services
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
signature	ΣTU	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.language	preferred	CommonLanguages Additional Bindings Purpose ​ AllLanguages Max Binding
Bundle.type	required	Pattern: collection
Bundle.entry.search.mode	required	SearchEntryMode
Bundle.entry.request.method	required	HTTPVerb
Bundle.entry:cancerPatient.search.mode	required	SearchEntryMode
Bundle.entry:cancerPatient.request.method	required	HTTPVerb

Differential View

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints
Bundle		0..*	Bundle	Contains a collection of resources
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Required Pattern: collection
timestamp	S	0..1	instant	When the bundle was assembled
Slices for entry	S	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource
entry:All Slices				Content/Rules for all slices
resource	S	1..1	Resource	A resource in the bundle
entry:cancerPatient	S	1..1	BackboneElement	Cancer Patient
resource		0..1	CancerPatient	Information about an individual or animal receiving health care services
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: collection
timestamp	SΣ	0..1	instant	When the bundle was assembled
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	SΣ	1..1	Resource	A resource in the bundle
entry:cancerPatient	SΣC	1..1	BackboneElement	Cancer Patient This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	S	0..1	CancerPatient	Information about an individual or animal receiving health care services
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.type	required	Pattern: collection

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose ​AllLanguages Max Binding
identifier	Σ	0..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: collection
timestamp	SΣ	0..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	SΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by profile:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:cancerPatient	SΣC	1..1	BackboneElement	Cancer Patient This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	0..1	CancerPatient	Information about an individual or animal receiving health care services
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
signature	ΣTU	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.language	preferred	CommonLanguages Additional Bindings Purpose ​ AllLanguages Max Binding
Bundle.type	required	Pattern: collection
Bundle.entry.search.mode	required	SearchEntryMode
Bundle.entry.request.method	required	HTTPVerb
Bundle.entry:cancerPatient.search.mode	required	SearchEntryMode
Bundle.entry:cancerPatient.request.method	required	HTTPVerb

This structure is derived from Bundle

Summary

Mandatory: 3 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)

Slices

This structure defines the following Slices:

• The element Bundle.entry is sliced based on the value of profile:resource