The subscription resource describes a particular client's request to be notified about a SubscriptionTopic.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

STU3: Subscription.criteria (new:string)

Element Subscription.criteria has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.criteria has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). The rules are a search criteria (without the [base] part). Like Bundle.entry.request.url, it has no leading "/".

STU3: Subscription.error (new:string)

Element Subscription.error has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.error has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.channel (new:BackboneElement)

Element Subscription.channel has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.channel has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.tag (new:Coding)

Element Subscription.tag has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.tag has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). So that other systems can tell which resources have been the subject of a notification.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The status of the subscription, which marks the server state for managing the subscription.

A client can only submit subscription resources in the requested or off state. Only the server can move a subscription from requested to active, and then to error. Either the server or the client can turn a subscription off.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

The status of a subscription.

The reference to the subscription topic to be notified about.

The type of channel to send notifications on.

The type of method used to execute a subscription.

STU3: Subscription.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

Element Subscription.meta is mapped to FHIR R5 element Subscription.meta as SourceIsBroaderThanTarget. The mappings for Subscription.meta do not cover the following types: Meta. The mappings for Subscription.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

STU3: Subscription.text additional types (Narrative) additional types from child elements (div, status)

Element Subscription.text is mapped to FHIR R5 element Subscription.text as SourceIsBroaderThanTarget. The mappings for Subscription.text do not cover the following types: Narrative. The mappings for Subscription.text do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

STU3: Subscription.criteria (new:string)

Element Subscription.criteria has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.criteria has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). The rules are a search criteria (without the [base] part). Like Bundle.entry.request.url, it has no leading "/".

STU3: Subscription.error (new:string)

Element Subscription.error has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.error has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.channel (new:BackboneElement)

Element Subscription.channel has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.channel has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.tag (new:Coding)

Element Subscription.tag has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.tag has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). So that other systems can tell which resources have been the subject of a notification.

STU3: Subscription.contact additional types (ContactPoint) additional types from child elements (period, rank, system, use, value)

Element Subscription.contact is mapped to FHIR R5 element Subscription.contact as SourceIsBroaderThanTarget. The mappings for Subscription.contact do not cover the following types: ContactPoint. The mappings for Subscription.contact do not cover the following types based on type expansion: period, rank, system, use, value.

The subscription resource describes a particular client's request to be notified about a SubscriptionTopic.

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

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

STU3: Subscription.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

Element Subscription.meta is mapped to FHIR R5 element Subscription.meta as SourceIsBroaderThanTarget. The mappings for Subscription.meta do not cover the following types: Meta. The mappings for Subscription.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

When the resource last changed - e.g. when the version changed.

This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Unless not suitable, these codes SHALL be taken from AllSecurityLabels
(extensible to http://hl7.org/fhir/ValueSet/security-labels|5.0.0)

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

IETF language tag for a human language

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

STU3: Subscription.text additional types (Narrative) additional types from child elements (div, status)

Element Subscription.text is mapped to FHIR R5 element Subscription.text as SourceIsBroaderThanTarget. The mappings for Subscription.text do not cover the following types: Narrative. The mappings for Subscription.text do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

The status of a resource narrative.

The actual narrative content, a stripped down version of XHTML.

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

STU3: Subscription.criteria (new:string)

Element Subscription.criteria has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.criteria has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). The rules are a search criteria (without the [base] part). Like Bundle.entry.request.url, it has no leading "/".

STU3: Subscription.error (new:string)

Element Subscription.error has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.error has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.channel (new:BackboneElement)

Element Subscription.channel has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.channel has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

STU3: Subscription.tag (new:Coding)

Element Subscription.tag has a context of Subscription based on following the parent source element upwards and mapping to Subscription. Element Subscription.tag has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). So that other systems can tell which resources have been the subject of a notification.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A formal identifier that is used to identify this code system when it is represented in other formats, or referenced in a specification, model, design or an instance.

A natural language name identifying the subscription.

The status of the subscription, which marks the server state for managing the subscription.

A client can only submit subscription resources in the requested or off state. Only the server can move a subscription from requested to active, and then to error. Either the server or the client can turn a subscription off.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

The status of a subscription.

The reference to the subscription topic to be notified about.

Contact details for a human to contact about the subscription. The primary use of this for system administrator troubleshooting.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

STU3: Subscription.contact additional types (ContactPoint) additional types from child elements (period, rank, system, use, value)

Element Subscription.contact is mapped to FHIR R5 element Subscription.contact as SourceIsBroaderThanTarget. The mappings for Subscription.contact do not cover the following types: ContactPoint. The mappings for Subscription.contact do not cover the following types based on type expansion: period, rank, system, use, value.

Telecommunications form for contact point - what communications system is required to make use of the contact.

Telecommunications form for contact point.

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Need to support legacy numbers that are not in a tightly controlled format.

Identifies the purpose for the contact point.

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Use of contact point.

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.

Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.

Time period when the contact point was/is in use.

The time for the server to turn the subscription off.

The server is permitted to deviate from this time but should observe it.

Entity with authorization to make subsequent revisions to the Subscription and also determines what data the subscription is authorized to disclose.

A description of why this subscription is defined.

The filter properties to be applied to narrow the subscription topic stream. When multiple filters are applied, evaluates to true if all the conditions applicable to that resource are met; otherwise it returns false (i.e., logical AND).

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A resource listed in the SubscriptionTopic this Subscription references (SubscriptionTopic.canFilterBy.resource). This element can be used to differentiate filters for topics that include more than one resource type.

A type of resource, or a Reference (from all versions)

The filter as defined in the SubscriptionTopic.canFilterBy.filterParameter element.

Comparator applied to this filter parameter.

Must be a comparator allowed by the SubscriptionTopic relevant to this Subscription filter.

Search Comparator Codes applied to this filter.

Modifier applied to this filter parameter.

Must be a modifier allowed by the SubscriptionTopic relevant to this Subscription filter.

Search Modifier Code applied to this filter.

The literal value or resource path as is legal in search - for example, Patient/123 or le1950.

The type of channel to send notifications on.

The type of method used to execute a subscription.

The url that describes the actual end-point to send notifications to.

For rest-hook the end-point must be an http: or https: URL; for websockets, ws: or wss:; for email, a mailto: url; and for message the endpoint can be in any form of url the server understands (usually, http/s: or mllp:). The URI is allowed to be relative; in which case, it is relative to the server end-point (since there may be more than one, clients should avoid using relative URIs).

Channel-dependent information to send as part of the notification (e.g., HTTP Headers).

Exactly what these mean depend on the channel type. They can convey additional information to the server or recipient and/or meet security requirements; for example, support of multiple headers in the outgoing notifications for rest-hook type subscriptions. Note that names are not required to be unique, but channel definitions can impose restrictions.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Parameter name for information passed to the channel for notifications, for example in the case of a REST hook wanting to pass through an authorization header, the name would be Authorization.

Parameter value for information passed to the channel for notifications, for example in the case of a REST hook wanting to pass through an authorization header, the value would be Bearer 0193....

If present, a 'heartbeat' notification (keep-alive) is sent via this channel with an interval period equal to this elements integer value in seconds. If not present, a heartbeat notification is not sent.

If present, the maximum amount of time a server will allow before failing a notification attempt.

The MIME type to send the payload in - e.g., application/fhir+xml or application/fhir+json. Note that:

• clients may request notifications in a specific FHIR version by using the FHIR Version Parameter - e.g., application/fhir+json; fhirVersion=4.0.

• additional MIME types can be allowed by channels - e.g., text/plain and text/html are defined by the Email channel.

BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

How much of the resource content to deliver in the notification payload. The choices are an empty payload, only the resource id, or the full resource content.

Sending the payload has obvious security implications. The server is responsible for ensuring that the content is appropriately secured.

Codes to represent how much resource content to send in the notification payload.

If present, the maximum number of events that will be included in a notification bundle. Note that this is not a strict limit on the number of entries in a bundle, as dependent resources can be included.