This page is part of the FHIR Specification v4.1.0: R4B Ballot. About the R4B version of FHIR. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

8.3 Resource Group - Content

FHIR Infrastructure

Work Group

Maturity Level: 1

Trial Use

Security Category: Business

Compartments: Device, Patient, Practitioner

Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.

8.3.1 Scope and Usage

8.3.1.1 Use Cases

The Group resource is used in one of two ways:

To define a group of specific people, animals, devices, etc. that is being tracked, examined or otherwise referenced as part of healthcare-related activities
To define a set of possible people, animals, devices, etc. that are of interest for some intended future healthcare-related activities

Examples of the former could include group therapy or treatment sessions, exposed entities tracked as part of public health, etc. The latter might be used to define expected subjects for a clinical study.

Both use cases are handled by a single resource because the data elements captured tend to be similar.

8.3.2 Boundaries and Relationships

There are a number of mechanisms in FHIR for communicating collections of resources:

The List resource - enumerates a flat collection of resources and provides features for managing the collection. While a particular List instance may represent a "snapshot", from a business process perspective the notion of "List" is dynamic – items are added and removed over time. The List resource references other resources. Lists may be curated and have specific business meaning.
This Group resource - defines a group of specific people, animals, devices etc. by enumerating them, or by describing qualities that group members have. The group resource refers to other resources, possibly implicitly. Groups are intended to be acted upon or observed as a whole; e.g. performing therapy on a group, calculating risk for a group, etc. This resource will commonly be used for public health (e.g. describing an at-risk population), clinical trials (e.g. defining a test subject pool) and similar purposes.
CareTeam. Group is distinct from CareTeam. Group is patient-independent and identifies an undifferentiated set of individuals who are intended to be the target of one or more clinical activities (e.g. set of clinical trial participants, set of individuals impacted by or at risk of a public health event, a herd or flock, etc.) The CareTeam resource establishes a set of relationships and roles and is specific to a particular Patient. The actors are the individual members or organized group of individuals. CareTeam can be referenced by EpisodeOfCare, Encounter, or CarePlan to identify the set of individuals (and their respective roles) who are intended to be involved in providing the care defined by those resources.
The Bundle resource - is an infrastructure container for a group of resources. It does not have narrative and is used to group collections of resources for transmission, persistence or processing (e.g. messages, documents, transactions, query responses, etc.) The content of bundles is typically algorithmically determined for a particular exchange or persistence purpose.
The Composition resource - defines a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. The composition resource provides the basic structure of a FHIR document. The full content of the document is expressed using a bundle. Compositions will often reference Lists as the focus of particular sections.
The DomainResource.contained element - allows multiple resources to be nested inside any DomainResource. This is a special type of grouping where the grouped resources lose independent existence - they no longer have their own identifiers, can't easily be queried independently, etc. Use of this grouping is a technical mechanism for managing the independence of resources and has no impact on meaning.

Contained, bundled and remotely referenced resources convey the same meaning.

8.3.3 References

This resource is referenced by DataRequirement, Statistic, UsageContext, ActivityDefinition, AdverseEvent, CarePlan, CareTeam, ChargeItem, ClinicalImpression, Communication, CommunicationRequest, Condition, Consent, Contract, DeviceRequest, DeviceUseStatement, DiagnosticReport, DocumentManifest, DocumentReference, Encounter, EventDefinition, Evidence, EvidenceReport, EvidenceVariable, Flag, Goal, itself, GuidanceResponse, ImagingStudy, Invoice, Library, List, Measure, MeasureReport, Media, MedicationAdministration, MedicationDispense, MedicationRequest, MedicationStatement, Observation, PlanDefinition, Procedure, RequestGroup, ResearchDefinition, ResearchElementDefinition, ResearchStudy, RiskAssessment, ServiceRequest, Specimen and Task.

This resource does not implement any patterns.

Structure

Name	Flags	Card.	Type	Description & Constraints
Group	TU		DomainResource	Group of multiple entities + Rule: Can only have members if group is "actual" Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Unique id
active	Σ	0..1	boolean	Whether this group's record is in active use
type	Σ	1..1	code	person \| animal \| practitioner \| device \| medication \| substance GroupType (Required)
actual	Σ I	1..1	boolean	Descriptive or actual
code	Σ	0..1	CodeableConcept	Kind of Group members GroupKind (Example)
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
managingEntity	Σ	0..1	Reference(Organization \| RelatedPerson \| Practitioner \| PractitionerRole)	Entity that is the custodian of the Group's definition
characteristic		0..*	BackboneElement	Include / Exclude group members by Trait
code		1..1	CodeableConcept	Kind of characteristic GroupCharacteristicKind (Example)
value[x]		1..1		Value held by characteristic GroupCharacteristicValue (Example)
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
valueReference			Reference()
exclude		1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	I	0..*	BackboneElement	Who or what is in group
entity		1..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Device \| Medication \| Substance \| Group)	Reference to the group member
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

UML Diagram (Legend)

XML Template

<Group xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique id --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this group's record is in active use -->
 <type value="[code]"/><!-- 1..1 person | animal | practitioner | device | medication | substance -->
 <actual value="[boolean]"/><!--  1..1 Descriptive or actual -->
 <code><!-- 0..1 CodeableConcept Kind of Group members --></code>
 <name value="[string]"/><!-- 0..1 Label for Group -->
 <quantity value="[unsignedInt]"/><!-- 0..1 Number of members -->
 <managingEntity><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) Entity that is the custodian of the Group's definition --></managingEntity>
 <characteristic>  <!-- 0..* Include / Exclude group members by Trait -->
  <code><!-- 1..1 CodeableConcept Kind of characteristic --></code>
  <value[x]><!-- 1..1 CodeableConcept|boolean|Quantity|Range|Reference Value held by characteristic --></value[x]>
  <exclude value="[boolean]"/><!-- 1..1 Group includes or excludes -->
  <period><!-- 0..1 Period Period over which characteristic is tested --></period>
 </characteristic>
 <member>  <!--  0..* Who or what is in group -->
  <entity><!-- 1..1 Reference(Device|Group|Medication|Patient|Practitioner|
    PractitionerRole|RelatedPerson|Substance) Reference to the group member --></entity>
  <period><!-- 0..1 Period Period member belonged to the group --></period>
  <inactive value="[boolean]"/><!-- 0..1 If member is no longer in group -->
 </member>
</Group>

JSON Template

{
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique id
  "active" : <boolean>, // Whether this group's record is in active use
  "type" : "<code>", // R!  person | animal | practitioner | device | medication | substance
  "actual" : <boolean>, // C? R!  Descriptive or actual
  "code" : { CodeableConcept }, // Kind of Group members
  "name" : "<string>", // Label for Group
  "quantity" : "<unsignedInt>", // Number of members
  "managingEntity" : { Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) }, // Entity that is the custodian of the Group's definition
  "characteristic" : [{ // Include / Exclude group members by Trait
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 5:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "valueReference" : { Reference },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "period" : { Period } // Period over which characteristic is tested
  }],
  "member" : [{ // C? Who or what is in group
    "entity" : { Reference(Device|Group|Medication|Patient|Practitioner|
    PractitionerRole|RelatedPerson|Substance) }, // R!  Reference to the group member
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Group;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Group.identifier [ Identifier ], ... ; # 0..* Unique id
  fhir:Group.active [ boolean ]; # 0..1 Whether this group's record is in active use
  fhir:Group.type [ code ]; # 1..1 person | animal | practitioner | device | medication | substance
  fhir:Group.actual [ boolean ]; # 1..1 Descriptive or actual
  fhir:Group.code [ CodeableConcept ]; # 0..1 Kind of Group members
  fhir:Group.name [ string ]; # 0..1 Label for Group
  fhir:Group.quantity [ unsignedInt ]; # 0..1 Number of members
  fhir:Group.managingEntity [ Reference(Organization|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Entity that is the custodian of the Group's definition
  fhir:Group.characteristic [ # 0..* Include / Exclude group members by Trait
    fhir:Group.characteristic.code [ CodeableConcept ]; # 1..1 Kind of characteristic
    # Group.characteristic.value[x] : 1..1 Value held by characteristic. One of these 5
      fhir:Group.characteristic.valueCodeableConcept [ CodeableConcept ]
      fhir:Group.characteristic.valueBoolean [ boolean ]
      fhir:Group.characteristic.valueQuantity [ Quantity ]
      fhir:Group.characteristic.valueRange [ Range ]
      fhir:Group.characteristic.valueReference [ Reference ]
    fhir:Group.characteristic.exclude [ boolean ]; # 1..1 Group includes or excludes
    fhir:Group.characteristic.period [ Period ]; # 0..1 Period over which characteristic is tested
  ], ...;
  fhir:Group.member [ # 0..* Who or what is in group
    fhir:Group.member.entity [ Reference(Device|Group|Medication|Patient|Practitioner|PractitionerRole|RelatedPerson|
  Substance) ]; # 1..1 Reference to the group member
    fhir:Group.member.period [ Period ]; # 0..1 Period member belonged to the group
    fhir:Group.member.inactive [ boolean ]; # 0..1 If member is no longer in group
  ], ...;
]

Changes since R3

Group

Group.type

Change value set from http://hl7.org/fhir/ValueSet/group-type|4.0.0 to http://hl7.org/fhir/ValueSet/group-type|4.1.0

Group.member.entity

Type Reference: Added Target Type RelatedPerson

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

Structure

Name	Flags	Card.	Type	Description & Constraints
Group	TU		DomainResource	Group of multiple entities + Rule: Can only have members if group is "actual" Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Unique id
active	Σ	0..1	boolean	Whether this group's record is in active use
type	Σ	1..1	code	person \| animal \| practitioner \| device \| medication \| substance GroupType (Required)
actual	Σ I	1..1	boolean	Descriptive or actual
code	Σ	0..1	CodeableConcept	Kind of Group members GroupKind (Example)
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
managingEntity	Σ	0..1	Reference(Organization \| RelatedPerson \| Practitioner \| PractitionerRole)	Entity that is the custodian of the Group's definition
characteristic		0..*	BackboneElement	Include / Exclude group members by Trait
code		1..1	CodeableConcept	Kind of characteristic GroupCharacteristicKind (Example)
value[x]		1..1		Value held by characteristic GroupCharacteristicValue (Example)
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
valueReference			Reference()
exclude		1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	I	0..*	BackboneElement	Who or what is in group
entity		1..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Device \| Medication \| Substance \| Group)	Reference to the group member
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

UML Diagram (Legend)

XML Template

<Group xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique id --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this group's record is in active use -->
 <type value="[code]"/><!-- 1..1 person | animal | practitioner | device | medication | substance -->
 <actual value="[boolean]"/><!--  1..1 Descriptive or actual -->
 <code><!-- 0..1 CodeableConcept Kind of Group members --></code>
 <name value="[string]"/><!-- 0..1 Label for Group -->
 <quantity value="[unsignedInt]"/><!-- 0..1 Number of members -->
 <managingEntity><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) Entity that is the custodian of the Group's definition --></managingEntity>
 <characteristic>  <!-- 0..* Include / Exclude group members by Trait -->
  <code><!-- 1..1 CodeableConcept Kind of characteristic --></code>
  <value[x]><!-- 1..1 CodeableConcept|boolean|Quantity|Range|Reference Value held by characteristic --></value[x]>
  <exclude value="[boolean]"/><!-- 1..1 Group includes or excludes -->
  <period><!-- 0..1 Period Period over which characteristic is tested --></period>
 </characteristic>
 <member>  <!--  0..* Who or what is in group -->
  <entity><!-- 1..1 Reference(Device|Group|Medication|Patient|Practitioner|
    PractitionerRole|RelatedPerson|Substance) Reference to the group member --></entity>
  <period><!-- 0..1 Period Period member belonged to the group --></period>
  <inactive value="[boolean]"/><!-- 0..1 If member is no longer in group -->
 </member>
</Group>

JSON Template

{
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique id
  "active" : <boolean>, // Whether this group's record is in active use
  "type" : "<code>", // R!  person | animal | practitioner | device | medication | substance
  "actual" : <boolean>, // C? R!  Descriptive or actual
  "code" : { CodeableConcept }, // Kind of Group members
  "name" : "<string>", // Label for Group
  "quantity" : "<unsignedInt>", // Number of members
  "managingEntity" : { Reference(Organization|Practitioner|PractitionerRole|
   RelatedPerson) }, // Entity that is the custodian of the Group's definition
  "characteristic" : [{ // Include / Exclude group members by Trait
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 5:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "valueReference" : { Reference },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "period" : { Period } // Period over which characteristic is tested
  }],
  "member" : [{ // C? Who or what is in group
    "entity" : { Reference(Device|Group|Medication|Patient|Practitioner|
    PractitionerRole|RelatedPerson|Substance) }, // R!  Reference to the group member
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Group;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Group.identifier [ Identifier ], ... ; # 0..* Unique id
  fhir:Group.active [ boolean ]; # 0..1 Whether this group's record is in active use
  fhir:Group.type [ code ]; # 1..1 person | animal | practitioner | device | medication | substance
  fhir:Group.actual [ boolean ]; # 1..1 Descriptive or actual
  fhir:Group.code [ CodeableConcept ]; # 0..1 Kind of Group members
  fhir:Group.name [ string ]; # 0..1 Label for Group
  fhir:Group.quantity [ unsignedInt ]; # 0..1 Number of members
  fhir:Group.managingEntity [ Reference(Organization|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Entity that is the custodian of the Group's definition
  fhir:Group.characteristic [ # 0..* Include / Exclude group members by Trait
    fhir:Group.characteristic.code [ CodeableConcept ]; # 1..1 Kind of characteristic
    # Group.characteristic.value[x] : 1..1 Value held by characteristic. One of these 5
      fhir:Group.characteristic.valueCodeableConcept [ CodeableConcept ]
      fhir:Group.characteristic.valueBoolean [ boolean ]
      fhir:Group.characteristic.valueQuantity [ Quantity ]
      fhir:Group.characteristic.valueRange [ Range ]
      fhir:Group.characteristic.valueReference [ Reference ]
    fhir:Group.characteristic.exclude [ boolean ]; # 1..1 Group includes or excludes
    fhir:Group.characteristic.period [ Period ]; # 0..1 Period over which characteristic is tested
  ], ...;
  fhir:Group.member [ # 0..* Who or what is in group
    fhir:Group.member.entity [ Reference(Device|Group|Medication|Patient|Practitioner|PractitionerRole|RelatedPerson|
  Substance) ]; # 1..1 Reference to the group member
    fhir:Group.member.period [ Period ]; # 0..1 Period member belonged to the group
    fhir:Group.member.inactive [ boolean ]; # 0..1 If member is no longer in group
  ], ...;
]

Changes since Release 3

Group

Group.type

Change value set from http://hl7.org/fhir/ValueSet/group-type|4.0.0 to http://hl7.org/fhir/ValueSet/group-type|4.1.0

Group.member.entity

Type Reference: Added Target Type RelatedPerson

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

8.3.4.1 Terminology Bindings

Path	Definition	Type	Reference
Group.type	Types of resources that are part of group.	Required	GroupType
Group.code	Kind of particular resource; e.g. cow, syringe, lake, etc.	Example	??
Group.characteristic.code	List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.	Example	??
Group.characteristic.value[x]	Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.	Example	??

Path

Definition

Type

Reference

Group.type

Types of resources that are part of group.

Required

GroupType

Group.code

Kind of particular resource; e.g. cow, syringe, lake, etc.

Example

Group.characteristic.code

List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

Example

Group.characteristic.value[x]

Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

Example

8.3.4.2 Constraints

Level

Location

Description

Expression

grp-1

Rule

(base)

Can only have members if group is "actual"

member.empty() or (actual = true)

8.3.4.3 Mixing Characteristics and Members

If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.

8.3.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
actual	token	Descriptive or actual	Group.actual
characteristic	token	Kind of characteristic	Group.characteristic.code
characteristic-value	composite	A composite of both characteristic and value	On Group.characteristic: characteristic: code value: value
code	token	The kind of resources contained	Group.code
exclude	token	Group includes or excludes	Group.characteristic.exclude
identifier	token	Unique id	Group.identifier
managing-entity	reference	Entity that is the custodian of the Group's definition	Group.managingEntity (Practitioner, Organization, PractitionerRole, RelatedPerson)
member	reference	Reference to the group member	Group.member.entity (Practitioner, Group, Device, Medication, Patient, Substance, PractitionerRole, RelatedPerson)
type	token	The type of resources the group contains	Group.type
value	token	Value held by characteristic	(Group.characteristic.value as CodeableConcept) \| (Group.characteristic.value as boolean)