The technical details of an endpoint that can be used for electronic services, such as for web services providing XDS.b or a REST endpoint for another FHIR server. This may include any security context information.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

An Extension

R5: Endpoint.description (new:string)

Element Endpoint.description has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.environmentType (new:CodeableConcept)

Element Endpoint.environmentType has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.environmentType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.payload.type (new:CodeableConcept)

Element Endpoint.payload.type has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.payload.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The mimeType describes the serialization format of the data, where the payload.type indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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.

active | suspended | error | off | test.

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

The status of the endpoint

A coded value that represents the technical details of the usage of this endpoint, such as what WSDLs should be used in what way. (e.g. XDS.b/DICOM/cds-hook).

For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example.

An Extension

R5: Endpoint.connectionType additional types (CodeableConcept) additional types from child elements (text)

Element Endpoint.connectionType is mapped to FHIR STU3 element Endpoint.connectionType as SourceIsBroaderThanTarget. The mappings for Endpoint.connectionType do not cover the following types: CodeableConcept. The mappings for Endpoint.connectionType do not cover the following types based on type expansion: text. For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example. If there are multiple payload types or mimetypes they are all applicable for all connection types, and all have the same status.

The payload type describes the acceptable content that can be communicated on the endpoint.

The payloadFormat describes the serialization format of the data, where the payloadType indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

The uri that describes the actual end-point to connect to.

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

This address will be to the service base, without any parameters, or sub-services or resources tacked on.

E.g. for a WADO-RS endpoint, the url should be "https://pacs.hospital.org/wado-rs"

and not "https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/...".

R5: Endpoint.description (new:string)

Element Endpoint.description has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.environmentType (new:CodeableConcept)

Element Endpoint.environmentType has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.environmentType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.payload.type (new:CodeableConcept)

Element Endpoint.payload.type has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.payload.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The mimeType describes the serialization format of the data, where the payload.type indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

R5: Endpoint.connectionType additional types (CodeableConcept) additional types from child elements (text)

Element Endpoint.connectionType is mapped to FHIR STU3 element Endpoint.connectionType as SourceIsBroaderThanTarget. The mappings for Endpoint.connectionType do not cover the following types: CodeableConcept. The mappings for Endpoint.connectionType do not cover the following types based on type expansion: text. For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example. If there are multiple payload types or mimetypes they are all applicable for all connection types, and all have the same status.

R5: Endpoint.managingOrganization additional types from child elements (display, identifier, reference, type)

Element Endpoint.managingOrganization is mapped to FHIR STU3 element Endpoint.managingOrganization as SourceIsBroaderThanTarget. The mappings for Endpoint.managingOrganization do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Endpoint.managingOrganization with unmapped reference targets: Organization. This property is not typically used when searching for Endpoint resources for usage. The typical usage is via the reference from an applicable Organization/Location/Practitioner resource, which is where the context is provided. Multiple Locations may reference a single endpoint, and don't have to be within the same organization resource, but most likely within the same organizational hierarchy.

The technical details of an endpoint that can be used for electronic services, such as for web services providing XDS.b or a REST endpoint for another FHIR server. This may include any security context information.

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

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

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).

Unless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

A human language.

A human-readable narrative that contains a summary of the resource, and may 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 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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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.

An Extension

R5: Endpoint.description (new:string)

Element Endpoint.description has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.environmentType (new:CodeableConcept)

Element Endpoint.environmentType has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.environmentType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Endpoint.payload.type (new:CodeableConcept)

Element Endpoint.payload.type has a context of Endpoint based on following the parent source element upwards and mapping to Endpoint. Element Endpoint.payload.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The mimeType describes the serialization format of the data, where the payload.type indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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.

Identifier for the organization that is used to identify the endpoint across multiple disparate systems.

active | suspended | error | off | test.

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

The status of the endpoint

A coded value that represents the technical details of the usage of this endpoint, such as what WSDLs should be used in what way. (e.g. XDS.b/DICOM/cds-hook).

For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example.

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

An Extension

R5: Endpoint.connectionType additional types (CodeableConcept) additional types from child elements (text)

Element Endpoint.connectionType is mapped to FHIR STU3 element Endpoint.connectionType as SourceIsBroaderThanTarget. The mappings for Endpoint.connectionType do not cover the following types: CodeableConcept. The mappings for Endpoint.connectionType do not cover the following types based on type expansion: text. For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example. If there are multiple payload types or mimetypes they are all applicable for all connection types, and all have the same status.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

A friendly name that this endpoint can be referred to with.

The organization that manages this endpoint (even if technically another organisation is hosting this in the cloud, it is the organisation associated with the data).

This property is not typically used when searching for Endpoint resources for usage. The typical usage is via the reference from an aplicable Organization/Location/Practitioner resource, which is where the context is provided. Multiple Locations may reference a single endpoint, and don't have to be within the same organization resource, but most likely within the same organizational hierarchy.

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

An Extension

R5: Endpoint.managingOrganization additional types from child elements (display, identifier, reference, type)

Element Endpoint.managingOrganization is mapped to FHIR STU3 element Endpoint.managingOrganization as SourceIsBroaderThanTarget. The mappings for Endpoint.managingOrganization do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Endpoint.managingOrganization with unmapped reference targets: Organization. This property is not typically used when searching for Endpoint resources for usage. The typical usage is via the reference from an applicable Organization/Location/Practitioner resource, which is where the context is provided. Multiple Locations may reference a single endpoint, and don't have to be within the same organization resource, but most likely within the same organizational hierarchy.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

The interval during which the endpoint is expected to be operational.

The payload type describes the acceptable content that can be communicated on the endpoint.

The payloadFormat describes the serialization format of the data, where the payloadType indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

The mime type to send the payload in - e.g. application/fhir+xml, application/fhir+json. If the mime type is not specified, then the sender could send any content (including no content depending on the connectionType).

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

The mime type of an attachment. Any valid mime type is allowed.

The uri that describes the actual end-point to connect to.

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

This address will be to the service base, without any parameters, or sub-services or resources tacked on.

E.g. for a WADO-RS endpoint, the url should be "https://pacs.hospital.org/wado-rs"

and not "https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/...".

Additional headers / information to send as part of the notification.

Exactly what these mean depend on the channel type. The can convey additional information to the recipient and/or meet security requirements.