This page is part of the National Healthcare Safety Network (NHSN) Digital Quality Measure (dQM) Reporting Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Examples
• XML
• JSON

Resource Profile: NHSN MeasureReport Bundle

This profile defines a valid Submission Bundle to NHSN with all resources contained within. The Bundle is comprised of entry slices representing the data source Organization, a POI List, one Subject List MeasureReport per reportable measure, an Individual MeasureReport List, individual MeasureReports, and the underlying patient-centric clinical information.

All resources referenced in the Bundle SHALL be present, per invariant bundle-contain-all-references. If an instance fails to validate against that invariant, the following FHIRPath statement can be used to locate the missing reference(s):

Usages:

• Examples for this Profile: Bundle/submission-full-example1
• CapabilityStatements using this Profile: NHSN MeasureReport Recipient CapabilityStatement

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bundle-no-modifier-extensions, bundle-contain-all-references
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
Slices for entry		1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource
entry:All Slices				Content/Rules for all slices
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Resource	A resource in the bundle
entry:submitting-organization	S	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data
resource		1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
entry:submitting-device	S	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data
resource		1..1	NHSNSubmittingDevice	Bundle entry for submitting device
entry:poi-list	S	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures
resource		1..1	PatientsOfInterestList	A list is a curated collection of resources
entry:subjectlist-measurereport	S	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary
resource		1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
entry:individual-measurereport-list	S	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary
resource		1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
entry:individual-measurereport	S	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List
resource		1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
entry:patient	S	0..*	BackboneElement	The Patients associated with an Individual MeasureReport
resource		1..1	QICorePatient	Information about an individual or animal receiving health care services
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bundle-no-modifier-extensions, bundle-contain-all-references
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. Fixed Value: collection
Slices for entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:submitting-organization	SΣC	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
entry:submitting-device	SΣC	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingDevice	Bundle entry for submitting device
entry:poi-list	SΣC	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	PatientsOfInterestList	A list is a curated collection of resources
entry:subjectlist-measurereport	SΣC	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
entry:individual-measurereport-list	SΣC	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
entry:individual-measurereport	SΣC	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
entry:patient	SΣC	0..*	BackboneElement	The Patients associated with an Individual MeasureReport Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	QICorePatient	Information about an individual or animal receiving health care services
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Bundle.type	required	Fixed Value: collection http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
bdl-1	error	Bundle	total only when a search or history : total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search : entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	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	error	Bundle	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-5	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	must be a resource unless there's a request or response : resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	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-8	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	fullUrl cannot be a version specific reference : fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value : type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date : type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource : type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource : type = 'message' implies entry.first().resource.is(MessageHeader)
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bundle-no-modifier-extensions, bundle-contain-all-references
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. Fixed Value: collection
timestamp	Σ	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	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource Constraints: bdl-5, bdl-8 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	SΣ	1..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:submitting-organization	SΣC	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
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:submitting-device	SΣC	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingDevice	Bundle entry for submitting device
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:poi-list	SΣC	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	PatientsOfInterestList	A list is a curated collection of resources
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:subjectlist-measurereport	SΣC	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
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:individual-measurereport-list	SΣC	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
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:individual-measurereport	SΣC	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
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:patient	SΣC	0..*	BackboneElement	The Patients associated with an Individual MeasureReport Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	QICorePatient	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	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Bundle.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Bundle.type	required	Fixed Value: collection http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 From the FHIR Standard
Bundle.entry.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:submitting-organization.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:submitting-organization.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:submitting-device.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:submitting-device.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:poi-list.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:poi-list.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:subjectlist-measurereport.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:subjectlist-measurereport.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport-list.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport-list.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:patient.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:patient.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
bdl-1	error	Bundle	total only when a search or history : total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search : entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	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	error	Bundle	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-5	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	must be a resource unless there's a request or response : resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	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-8	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	fullUrl cannot be a version specific reference : fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value : type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date : type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource : type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource : type = 'message' implies entry.first().resource.is(MessageHeader)
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Bundle

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 9 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• NHSN Submitting Organization (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/nhsn-submitting-organization)
• NHSN Submitting Device (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/nhsn-submitting-device)
• Patients-Of-Interest List (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/poi-list)
• DEQM Subject List MeasureReport (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/subjectlist-measurereport-deqm)
• DEQM Individual MeasureReport List (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-list)
• DEQM Individual MeasureReport Profile (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Bundle.entry

Maturity: 1

Differential View

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bundle-no-modifier-extensions, bundle-contain-all-references
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
Slices for entry		1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource
entry:All Slices				Content/Rules for all slices
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Resource	A resource in the bundle
entry:submitting-organization	S	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data
resource		1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
entry:submitting-device	S	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data
resource		1..1	NHSNSubmittingDevice	Bundle entry for submitting device
entry:poi-list	S	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures
resource		1..1	PatientsOfInterestList	A list is a curated collection of resources
entry:subjectlist-measurereport	S	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary
resource		1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
entry:individual-measurereport-list	S	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary
resource		1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
entry:individual-measurereport	S	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List
resource		1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
entry:patient	S	0..*	BackboneElement	The Patients associated with an Individual MeasureReport
resource		1..1	QICorePatient	Information about an individual or animal receiving health care services
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bundle-no-modifier-extensions, bundle-contain-all-references
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. Fixed Value: collection
Slices for entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:submitting-organization	SΣC	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
entry:submitting-device	SΣC	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingDevice	Bundle entry for submitting device
entry:poi-list	SΣC	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	PatientsOfInterestList	A list is a curated collection of resources
entry:subjectlist-measurereport	SΣC	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
entry:individual-measurereport-list	SΣC	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
entry:individual-measurereport	SΣC	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
entry:patient	SΣC	0..*	BackboneElement	The Patients associated with an Individual MeasureReport Constraints: bdl-5, bdl-8 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
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	QICorePatient	Information about an individual or animal receiving health care services
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Bundle.type	required	Fixed Value: collection http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
bdl-1	error	Bundle	total only when a search or history : total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search : entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	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	error	Bundle	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-5	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	must be a resource unless there's a request or response : resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	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-8	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	fullUrl cannot be a version specific reference : fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value : type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date : type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource : type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource : type = 'message' implies entry.first().resource.is(MessageHeader)
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	A Bundle contains a collection of Resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bundle-no-modifier-extensions, bundle-contain-all-references
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. Fixed Value: collection
timestamp	Σ	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	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource, profile:resource Constraints: bdl-5, bdl-8 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	SΣ	1..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:submitting-organization	SΣC	1..1	BackboneElement	The Submitting Organization: the organization that is the source of the data Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingOrganization	Bundle entry for submitting organization
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:submitting-device	SΣC	0..1	BackboneElement	The Submitting Device: the device or software that is submitting the data Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	NHSNSubmittingDevice	Bundle entry for submitting device
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:poi-list	SΣC	0..1	BackboneElement	The Patients of Interest List: a List containing Patient FHIR IDs that may be included in the Initial Population across all measures Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	PatientsOfInterestList	A list is a curated collection of resources
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:subjectlist-measurereport	SΣC	0..*	BackboneElement	Subject List MeasureReport: For each measure, there is one Summary MeasureReport. The Summary MeasureReport includes the population count and a link to the List of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMSubjectListMeasureReport	Results of a measure evaluation
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:individual-measurereport-list	SΣC	0..*	BackboneElement	Individual MeasureReport List: Each Summary MeasureReport references a list of Individual MeasureReports that are included in the summary Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportList	A list is a curated collection of resources
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:individual-measurereport	SΣC	0..*	BackboneElement	Individual Measure Report: each Individual MeasureReport refers to one Patient and one measure included in the Individual Measure Report List Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	DEQMIndividualMeasureReportProfile	Results of a measure evaluation
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:patient	SΣC	0..*	BackboneElement	The Patients associated with an Individual MeasureReport Constraints: bdl-5, bdl-8 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	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	QICorePatient	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	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Bundle.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Bundle.type	required	Fixed Value: collection http://hl7.org/fhir/ValueSet/bundle-type|4.0.1 From the FHIR Standard
Bundle.entry.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:submitting-organization.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:submitting-organization.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:submitting-device.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:submitting-device.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:poi-list.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:poi-list.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:subjectlist-measurereport.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:subjectlist-measurereport.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport-list.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport-list.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:individual-measurereport.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard
Bundle.entry:patient.search.mode	required	SearchEntryMode http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1 From the FHIR Standard
Bundle.entry:patient.request.method	required	HTTPVerb http://hl7.org/fhir/ValueSet/http-verb|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
bdl-1	error	Bundle	total only when a search or history : total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search : entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	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	error	Bundle	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-5	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	must be a resource unless there's a request or response : resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	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-8	error	Bundle.entry, Bundle.entry:submitting-organization, Bundle.entry:submitting-device, Bundle.entry:poi-list, Bundle.entry:subjectlist-measurereport, Bundle.entry:individual-measurereport-list, Bundle.entry:individual-measurereport, Bundle.entry:patient	fullUrl cannot be a version specific reference : fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value : type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date : type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource : type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource : type = 'message' implies entry.first().resource.is(MessageHeader)
bundle-contain-all-references	error	Bundle	All referenced resources SHALL be contained within the Bundle. : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))
bundle-no-modifier-extensions	error	Bundle	MeasureReport Bundle: must not contain any modifierExensions : (descendants().select(modifierExtension)).exists().not()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Bundle

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 9 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• NHSN Submitting Organization (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/nhsn-submitting-organization)
• NHSN Submitting Device (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/nhsn-submitting-device)
• Patients-Of-Interest List (http://hl7.org/fhir/us/nhsn-dqm/StructureDefinition/poi-list)
• DEQM Subject List MeasureReport (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/subjectlist-measurereport-deqm)
• DEQM Individual MeasureReport List (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-list)
• DEQM Individual MeasureReport Profile (http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Bundle.entry

Maturity: 1