# US Situational Awareness Framework for Reporting Home - US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide v1.0.0

* [**Table of Contents**](toc.md)
* **US Situational Awareness Framework for Reporting Home**

## US Situational Awareness Framework for Reporting Home

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/safr/ImplementationGuide/hl7.fhir.us.safr | *Version*:1.0.0 | |
| * IG Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 2 | *Computable Name*:USSAFR |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.53 | | |

### Overview

The US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide (IG) establishes a standardized, FHIR-based approach to support public health decision-making during emergencies. By enhancing situational awareness, this IG aims to provide a real-time, national or jurisdictional view of healthcare system capacity, respiratory disease trends, and other critical public health metrics. The guide is designed to facilitate seamless data exchange between healthcare facilities and public health authorities (federal and/or jurisdictional),thereby strengthening the nation’s emergency preparedness and response capabilities.

### Purpose

This specification seeks to achieve the following objectives:

1. **Standardized FHIR Interfaces:**Enable interoperable data exchange with the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC) and other federal or jurisdictional public health agencies.
1. **Automated Data Collection:**Minimize manual intervention through real-time data collection.
1. **Increased Situational Awareness:**Provide a comprehensive view of healthcare capacity and trends, serving as a foundation for future data reporting needs.

By addressing these goals, US SAFR supports healthcare facilities and public health authorities in reporting critical data efficiently, ensuring patient safety and informed decision-making during public health emergencies.

### Background

The COVID-19 pandemic revealed significant gaps in the ability to monitor healthcare system stress and capacity. This project integrates and generalizes previous initiatives, including [SANER - Situational Awareness for Novel Epidemic Response IG (universal realm)](https://build.fhir.org/ig/HL7/fhir-saner/index.html) and [DEQM - Data Exchange for Quality Measure IG (US realm)](http://hl7.org/fhir/us/davinci-deqm/STU5/index.html), into a unified framework tailored for the US. Key highlights include:

1. Standardized definitions of healthcare bed capacity and other metrics.
1. Compatibility with existing federal systems and regulatory requirements.
1. Development of at least one IG tailored for US-specific needs, leveraging United States Core Data for Interoperability (USCDI) and US terminology. The US SAFR IG builds upon lessons learned during the pandemic to create a reliable, automated, and standardized reporting framework for the future.

### Audience

This guide is intended for a broad range of interoperability partners, including:

* **Healthcare Organizations:** Hospitals, acute care centers, and other providers with public health reporting obligations.
* **Federal Agencies:** CDC, ASTP/ONC, CMS, ASPR, and other federal public health entities.
* **Provider HIT Vendors:** Developers of provider HIT such as EHRs, administrative, and logistics systems that are the source of US SAFR data.
* **Standards Development Organizations:** Stakeholders involved in advancing FHIR and other health data standards.
* **Public Health Authorities:** State, tribal, local, and territorial (STLTs) public health agencies seeking to improve situational awareness and emergency response.

### Design Considerations

The design of US SAFR emphasizes:

* **Interoperability:** Seamless data exchange between hospitals, jurisdictions, and federal systems via FHIR.
* **Scalability:** A framework capable of addressing both current and future situational awareness needs.
* **Data Uniformity:** Consistent definitions and structures to facilitate regional and national collaboration.
* **Automated Compliance:** Streamlined reporting aligned with federal regulations to reduce the administrative burden.

The guide ensures alignment with existing initiatives, such as SANER and DEQM, while addressing US-specific requirements and terminology.

### Relationship to Other Standards

The US SAFR IG harmonizes with and extends the following standards:

1. **[SANER (Universal Realm):](https://build.fhir.org/ig/HL7/fhir-saner/index.html)**Provides the foundation for situational awareness reporting globally. US SAFR adapts SANER for US-specific requirements while maintaining interoperability.
1. **[DEQM (US Realm):](http://hl7.org/fhir/us/davinci-deqm/STU5/index.html)**Ensures alignment with existing US-specific quality measurement standards.
1. **[NHSN Bed Connectivity Initiative:](https://www.cdc.gov/nhsn/bed-capacity/index.html)**Standardizes real-time bed capacity reporting across hospitals and jurisdictions.
1. **[Hospital Respiratory Data Reporting:](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html)**Establishes reporting standards for COVID-19, influenza, RSV, and related data.
1. **[NHSN dQM Reporting:](http://hl7.org/fhir/us/nhsn-dqm/ImplementationGuide/hl7.fhir.us.nhsn-dqm)**Defines the standard framework for reporting patient line-level clinical data using a digital Quality Measure (dQM). Whereas, US SAFR focuses on situational awareness reporting excluding protected health information.

By aligning with these standards, US SAFR supports a unified reporting framework for healthcare capacity and situational awareness data.

Other FHIR standard related dependencies:















ValueSet Expansion Parameters

* Parameter: system-version
  * Value: SNOMED CT[US]

### Out of Scope

Subscriptions is not covered in this IG currently, but future versions will plan to incorporate [FHIR Subscriptions R5 Backport](https://build.fhir.org/ig/HL7/fhir-subscription-backport-ig/) to support emergencies that require rapid changes in reporting.

### Acknowledgements

This implementation guide is a product of the [HL7 International–Public Health Work Group](http://www.hl7.org/Special/committees/pher/).



## Resource Content

```json
{
  "resourceType" : "ImplementationGuide",
  "id" : "hl7.fhir.us.safr",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 2
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "pher"
  }],
  "url" : "http://hl7.org/fhir/us/safr/ImplementationGuide/hl7.fhir.us.safr",
  "version" : "1.0.0",
  "name" : "USSAFR",
  "title" : "US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide",
  "status" : "active",
  "date" : "2026-04-01T02:56:48+11:00",
  "publisher" : "HL7 International / Public Health",
  "contact" : [{
    "name" : "HL7 International / Public Health",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/pher"
    }]
  }],
  "description" : "US Situational Awareness Framework for Reporting (US SAFR)",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }]
  }],
  "packageId" : "hl7.fhir.us.safr",
  "license" : "CC0-1.0",
  "fhirVersion" : ["4.0.1"],
  "dependsOn" : [{
    "id" : "hl7tx",
    "extension" : [{
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/implementationguide-dependency-comment",
      "valueMarkdown" : "Automatically added as a dependency - all IGs depend on HL7 Terminology"
    }],
    "uri" : "http://terminology.hl7.org/ImplementationGuide/hl7.terminology",
    "packageId" : "hl7.terminology.r4",
    "version" : "7.1.0"
  },
  {
    "id" : "hl7ext",
    "extension" : [{
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/implementationguide-dependency-comment",
      "valueMarkdown" : "Automatically added as a dependency - all IGs depend on the HL7 Extension Pack"
    }],
    "uri" : "http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions",
    "packageId" : "hl7.fhir.uv.extensions.r4",
    "version" : "5.2.0"
  },
  {
    "id" : "uscore",
    "uri" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core",
    "packageId" : "hl7.fhir.us.core",
    "version" : "6.1.0"
  },
  {
    "id" : "cqf",
    "uri" : "http://fhir.org/guides/cqf/common/ImplementationGuide/fhir.cqf.common",
    "packageId" : "fhir.cqf.common",
    "version" : "4.0.1"
  },
  {
    "id" : "crmi",
    "uri" : "http://hl7.org/fhir/uv/crmi/ImplementationGuide/hl7.fhir.uv.crmi",
    "packageId" : "hl7.fhir.uv.crmi",
    "version" : "1.0.0"
  },
  {
    "id" : "cqfm",
    "uri" : "http://hl7.org/fhir/us/cqfmeasures/ImplementationGuide/hl7.fhir.us.cqfmeasures",
    "packageId" : "hl7.fhir.us.cqfmeasures",
    "version" : "5.0.0"
  },
  {
    "id" : "deqm",
    "uri" : "http://hl7.org/fhir/us/davinci-deqm/ImplementationGuide/hl7.fhir.us.davinci-deqm",
    "packageId" : "hl7.fhir.us.davinci-deqm",
    "version" : "5.0.0"
  },
  {
    "id" : "hl7_fhir_us_qicore",
    "uri" : "http://hl7.org/fhir/us/qicore/ImplementationGuide/hl7.fhir.us.qicore",
    "packageId" : "hl7.fhir.us.qicore",
    "version" : "6.0.0"
  }],
  "definition" : {
    "extension" : [{
      "extension" : [{
        "url" : "code",
        "valueString" : "copyrightyear"
      },
      {
        "url" : "value",
        "valueString" : "2026+"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "releaselabel"
      },
      {
        "url" : "value",
        "valueString" : "STU 1"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-expansion-params"
      },
      {
        "url" : "value",
        "valueString" : "../../input/exp-params.json"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "active-tables"
      },
      {
        "url" : "value",
        "valueString" : "false"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-contact"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-jurisdiction"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-publisher"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-version"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "show-inherited-invariants"
      },
      {
        "url" : "value",
        "valueString" : "false"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "pin-canonicals"
      },
      {
        "url" : "value",
        "valueString" : "pin-multiples"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "templates\\liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "auto-oid-root"
      },
      {
        "url" : "value",
        "valueString" : "2.16.840.1.113883.4.642.40.53"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-history"
      },
      {
        "url" : "value",
        "valueString" : "http://hl7.org/fhir/us/safr/history.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "autoload-resources"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "template/liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "input/liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-qa"
      },
      {
        "url" : "value",
        "valueString" : "temp/qa"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-temp"
      },
      {
        "url" : "value",
        "valueString" : "temp/pages"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-output"
      },
      {
        "url" : "value",
        "valueString" : "output"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "path-suppressed-warnings"
      },
      {
        "url" : "value",
        "valueString" : "input/ignoreWarnings.txt"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "template-html"
      },
      {
        "url" : "value",
        "valueString" : "template-page.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "template-md"
      },
      {
        "url" : "value",
        "valueString" : "template-page-md.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-context"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-copyright"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-license"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "apply-wg"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "fmm-definition"
      },
      {
        "url" : "value",
        "valueString" : "http://hl7.org/fhir/versions.html#maturity"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "propagate-status"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "excludelogbinaryformat"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueString" : "tabbed-snapshots"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/expansion-parameters",
      "valueReference" : {
        "reference" : "Parameters/expansion-parameters"
      }
    },
    {
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-internal-dependency",
      "valueCode" : "hl7.fhir.uv.tools.r4#1.1.2"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "copyrightyear"
      },
      {
        "url" : "value",
        "valueString" : "2026+"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "releaselabel"
      },
      {
        "url" : "value",
        "valueString" : "STU 1"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-expansion-params"
      },
      {
        "url" : "value",
        "valueString" : "../../input/exp-params.json"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "active-tables"
      },
      {
        "url" : "value",
        "valueString" : "false"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-contact"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-jurisdiction"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-publisher"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-version"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "show-inherited-invariants"
      },
      {
        "url" : "value",
        "valueString" : "false"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "pin-canonicals"
      },
      {
        "url" : "value",
        "valueString" : "pin-multiples"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "templates\\liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "auto-oid-root"
      },
      {
        "url" : "value",
        "valueString" : "2.16.840.1.113883.4.642.40.53"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-history"
      },
      {
        "url" : "value",
        "valueString" : "http://hl7.org/fhir/us/safr/history.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "autoload-resources"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "template/liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-liquid"
      },
      {
        "url" : "value",
        "valueString" : "input/liquid"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-qa"
      },
      {
        "url" : "value",
        "valueString" : "temp/qa"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-temp"
      },
      {
        "url" : "value",
        "valueString" : "temp/pages"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-output"
      },
      {
        "url" : "value",
        "valueString" : "output"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-suppressed-warnings"
      },
      {
        "url" : "value",
        "valueString" : "input/ignoreWarnings.txt"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "template-html"
      },
      {
        "url" : "value",
        "valueString" : "template-page.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "template-md"
      },
      {
        "url" : "value",
        "valueString" : "template-page-md.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-context"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-copyright"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-license"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-wg"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "fmm-definition"
      },
      {
        "url" : "value",
        "valueString" : "http://hl7.org/fhir/versions.html#maturity"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "propagate-status"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "excludelogbinaryformat"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "tabbed-snapshots"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    }],
    "resource" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CodeSystem"
      }],
      "reference" : {
        "reference" : "CodeSystem/us-safr-bed-capacity-example-codes"
      },
      "name" : "BedCapacityExampleCS",
      "description" : "Healthcare Bed Capacity Reporting Code System",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Library"
      }],
      "reference" : {
        "reference" : "Library/BedCapacityMeasure"
      },
      "name" : "BedCapacityMeasure",
      "description" : "Example Bed Capacity Measure Library",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Measure"
      }],
      "reference" : {
        "reference" : "Measure/BedCapacityMeasureExample"
      },
      "name" : "BedCapacityMeasureExample",
      "description" : "Example Bed Capacity Measure",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/HospitalBedCapacityReportBundle"
      },
      "name" : "Bundle - Bed Capacity Report Bundle Example",
      "description" : "Bundle containing a measure report and all referenced resources for NHSN bed capacity reporting.",
      "exampleCanonical" : "http://hl7.org/fhir/us/safr/StructureDefinition/us-safr-measurereport-bundle"
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/HRDMeasureReportBundle"
      },
      "name" : "Bundle - HRD Measure Report Bundle Example",
      "description" : "Bundle containing a measure report and all referenced resources for NHSN Hospital Respiratory Disease (HRD) reporting",
      "exampleCanonical" : "http://hl7.org/fhir/us/safr/StructureDefinition/us-safr-measurereport-bundle"
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/USSAFRMeasureBundleExample"
      },
      "name" : "Bundle - US SAFR Measure Bundle Example",
      "description" : "Bundle containing a measure for NHSN reporting.",
      "exampleCanonical" : "http://hl7.org/fhir/us/safr/StructureDefinition/us-safr-measure-bundle"
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/CHLDBed4"
      },
      "name" : "Children's Bed 4",
      "description" : "A bed located in the Children's Department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Device"
      }],
      "reference" : {
        "reference" : "Device/cqf-tooling"
      },
      "name" : "Device - CQF Tooling System Example",
      "description" : "Example of a Software System Device instance for describing tooling that was used to process artifacts.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/EDBed1"
      },
      "name" : "Emergency Dept. Bed 1",
      "description" : "A bed located in the Emergency Department.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Encounter"
      }],
      "reference" : {
        "reference" : "Encounter/encounter-example-ach-ach-pass2-emergency"
      },
      "name" : "Encounter - Example ACH Pass2 - Emergency",
      "description" : "Encounter - Example ACH Pass2 - Emergency department visit",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CodeSystem"
      }],
      "reference" : {
        "reference" : "CodeSystem/us-safr-hrd-example-codes"
      },
      "name" : "HRDExampleCS",
      "description" : "Hospital Respiratory Data Reporting Code System",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Library"
      }],
      "reference" : {
        "reference" : "Library/HRDMeasure"
      },
      "name" : "HRDMeasure",
      "description" : "Example Hospital Respiratory Data Measure Library",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Measure"
      }],
      "reference" : {
        "reference" : "Measure/HRDMeasureExample"
      },
      "name" : "HRDMeasureExample",
      "description" : "Example Hospital Respiratory Data Measure",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/IPFBed3"
      },
      "name" : "Inpatient Psychiatric Bed 3",
      "description" : "A bed located in the Inpatient Psychiatric Department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/IRFBed2"
      },
      "name" : "Inpatient Rehabilitation Bed 2",
      "description" : "A bed located in Inpatient Rehabilitation department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/ICUBed6"
      },
      "name" : "Intensive Care Unit Bed 6",
      "description" : "A bed located in the ICU Unit of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/MemorialHospitalFacility"
      },
      "name" : "Location - Hospital Facility Example",
      "description" : "Example of a Hospital Facility for NHSN reporting.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "MeasureReport"
      }],
      "reference" : {
        "reference" : "MeasureReport/BedCapacityMeasureReport"
      },
      "name" : "MeasureReport - Bed Capacity MeasureReport Example",
      "description" : "Example MeasureReport for NHSN bed capacity monitoring showing ICU, ED, and Pediatric bed capacity",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "MeasureReport"
      }],
      "reference" : {
        "reference" : "MeasureReport/HRDMeasureReport"
      },
      "name" : "MeasureReport - HRD MeasureReport Example",
      "description" : "This Bundle resource is an example of a Hospital Respiratory Data (HRD) MeasureReport.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Organization"
      }],
      "reference" : {
        "reference" : "Organization/MemorialHospitalOrganization"
      },
      "name" : "Organization - Submitting Hospital Organization Example",
      "description" : "Organization - Example of a Submitting Hospital Organization",
      "exampleCanonical" : "http://hl7.org/fhir/us/safr/StructureDefinition/us-safr-submitting-organization"
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/OTHBed5"
      },
      "name" : "Other Facility Bed 3",
      "description" : "A bed located in an subunit of the facility.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Patient"
      }],
      "reference" : {
        "reference" : "Patient/ed-pat-1"
      },
      "name" : "Patient - Example ED Patient 1",
      "description" : "Patient - Example of a and Emergency Department patient",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/PEDSBed7"
      },
      "name" : "Pediatric Bed 7",
      "description" : "A bed located in the Pediatrics Unit of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "StructureDefinition:resource"
      }],
      "reference" : {
        "reference" : "StructureDefinition/us-safr-measure-bundle"
      },
      "name" : "US SAFR Measure Bundle",
      "description" : "This profile defines a Bundle provided by the MeasureServer containing a Measure resource and enables the inclusion of all related resources (ValueSet, Library, etc.).\n\nIf this fails, use the following FHIRPath expression to discover missing resources: \nBundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).where((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')).not())",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "StructureDefinition:resource"
      }],
      "reference" : {
        "reference" : "StructureDefinition/us-safr-measurereport-bundle"
      },
      "name" : "US SAFR Measure Report Bundle",
      "description" : "This profile defines a valid submission bundle to NHSN, federal and jurisdictional Public Health Agencies including State, Tribal, Local and Territorial (STLT) Health Departments with all resources contained within. The Bundle is comprised of entry slices representing the data \nsubmitting organization, submitting device, and individual MeasureReports.\n\nIf this fails, use the following FHIRPath expression to discover missing resources: \nBundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).where((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')).not())",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "StructureDefinition:resource"
      }],
      "reference" : {
        "reference" : "StructureDefinition/us-safr-submitting-organization"
      },
      "name" : "US SAFR Submitting Organization",
      "description" : "This profile includes the name and identifier of the organization submitting the report Bundle, and may include other information about the organization.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "ValueSet"
      }],
      "reference" : {
        "reference" : "ValueSet/us-safr-hrd-supply-days-example-codes"
      },
      "name" : "USSAFRSupplyDaysExampleVS",
      "description" : "Hospital Respiratory Data Supply Days Value Set",
      "exampleBoolean" : true
    }],
    "page" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
        "valueCode" : "informative"
      },
      {
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
        "valueUrl" : "toc.html"
      }],
      "nameUrl" : "toc.html",
      "title" : "Table of Contents",
      "generation" : "html",
      "page" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "index.html"
        }],
        "nameUrl" : "index.html",
        "title" : "US Situational Awareness Framework for Reporting Home",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "actors.html"
        }],
        "nameUrl" : "actors.html",
        "title" : "actors",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "usecases.html"
        }],
        "nameUrl" : "usecases.html",
        "title" : "Use Cases",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "specification.html"
        }],
        "nameUrl" : "specification.html",
        "title" : "Specification",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "security.html"
        }],
        "nameUrl" : "security.html",
        "title" : "Security",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "downloads.html"
        }],
        "nameUrl" : "downloads.html",
        "title" : "Downloads",
        "generation" : "markdown"
      }]
    },
    "parameter" : [{
      "code" : "path-resource",
      "value" : "input/capabilities"
    },
    {
      "code" : "path-resource",
      "value" : "input/examples"
    },
    {
      "code" : "path-resource",
      "value" : "input/extensions"
    },
    {
      "code" : "path-resource",
      "value" : "input/models"
    },
    {
      "code" : "path-resource",
      "value" : "input/operations"
    },
    {
      "code" : "path-resource",
      "value" : "input/profiles"
    },
    {
      "code" : "path-resource",
      "value" : "input/resources"
    },
    {
      "code" : "path-resource",
      "value" : "input/vocabulary"
    },
    {
      "code" : "path-resource",
      "value" : "input/maps"
    },
    {
      "code" : "path-resource",
      "value" : "input/testing"
    },
    {
      "code" : "path-resource",
      "value" : "input/history"
    },
    {
      "code" : "path-resource",
      "value" : "fsh-generated/resources"
    },
    {
      "code" : "path-pages",
      "value" : "template/config"
    },
    {
      "code" : "path-pages",
      "value" : "input/images"
    },
    {
      "code" : "path-tx-cache",
      "value" : "input-cache/txcache"
    }]
  }
}

```
