This page is part of FHIR DSTU 1 (v0.0.82) in it's permanent home (it will always be available at this URL). It has been superceded by R4. For a full list of available versions, see the Directory of published versions .. Page versions: R5 R4B R4 R3 R2

1.4 Version History

1.4.1 Ongoing releases of the DSTU

This version of the FHIR is the DSTU, as published on Feb-3 2014. The date at the foot of the pages is more recent because of ongoing releases to the FHIR version. Subsequent releases:

• Sept 29, 2014 0.0.82: Fix error in JSON examples, update to the license and trademark terms, and updated reference implementations.
  • The license has been changed to a Creative Commons license (instead of the one adapted from OMG). There is no change in the intent or effect of the license. The use of the FHIR related trademarks has been clarified
  • Java Reference Implementation: Fix major bug in reading/writing JSON instances: the json equivalent for xml:id is specified as "id" but the java reference implementation had been using "_id". This is a breaking changed for users of the JSON representation using the Java reference implementation.. Note also that this means that all the example JSON instances in the specification were wrong; these have also been fixed in this update.
  • Java Reference Implementation: rename primitive types from X to XType (or String_ to StringType). Fix bug in parser related to xml whitespace parsing. Add UCUM support. Many improvements to the validation jar (including profile based validation). Link to Maven explicitly
  • Pascal Reference Implementation: many minor fixes to supporting code, and flip *ST properties to be the main property and use *Object for the underlying object
• May-8 2014: Change version to 0.0.81 (from 0.80) to align with new versioning policy, security alert about Narrative, clarify rules around the status of content, and reference implementation updates
  • DSTU note: Add clarification about what content is formally part of the specification, and the status of examples
  • Schema: tighten the schema to enforce the rules about narrative in the specification. Also, reorganize the schema constraint groups for DotNet compatibility
  • All Reference Implementations: Change the way version numbering works - the reference implementations have their own version now, in addition to the FHIR version
  • Java: Fix major bug in reading/writing JSON bundles. The specification changed so that there was "resourceType" : "Bundle" instead of a surrounding "feed" object, but the Java implementation hadn't been changed. This meant that the java implementation wasn't consistent with the specification or the other reference implementations, and it meant that the example JSON bundles in the specification were wrong; these have also been fixed
  • Java: Enforce FHIR rules about narrative (no active content), various fixes to the client for history and tags
  • Pascal: Change minor error in list generation, enforce narrative rules (no active content), better handling of relative references,
  • C#/.Net: Enforce FHIR rules about narrative (no active content), plus many others changes (see http://ewoutkramer.github.io/fhir-net-api/whats-new.html)
  • ObjectiveC: rename Resource to BaseResource and ResourceReference to Resource
  • Javascript: Add the Javascript implementation
• Apr-3 2014: Fix archive links (below), add link to HIMSS video on home page, and reference platform changes:
  • Java: Re-organise dependencies in the parsers so that JSON serialiser doesn't include XmlPullParser
  • ObjectiveC: rename Resource to BaseResource and ResourceReference to Resource

1.4 Significant Changes

From the DSTU version going forward, this page will track the important changes to the specification. Note that an absolute full version history is available from the FHIR SVN

1.4.1 From DSTU ballot (v0.11) to the full DSTU (0.50?)

1.4.1.1 Infrastructure

• Resource References:
  • make a rule that any contained resources must be explicitly referred to from other content in the resource
  • remove "type" element - it had no actual function
• Bundles:
  • add the "fhir-base" link that SHALL be present if relative references are found in the bundle
  • Documents & Messages: document that these are marked with tags to identify them
• Tags:
  • Add defined security tags (labels), including some common security labels
  • Added Profile tags, and explained how they are used for validatio
• Extensions:
  • make rules around obligations for exchange
  • Split out extensions and modifierExtensions
• JSON:
  • rename "_id" to "id"
  • change the way that primitive types are represented (split id and extension out into _[name])
  • change the way bundles and resources are represented at the base ("resourceType" property)
• REST API:
  • The syntax of the URLs has changed (remove @ from the ids)
  • resources are no longer returned on create/update/transaction
  • rules around the transction response have changed
  • CORS is now recommended (and in the conformance resource)
• Searching:
  • clarify that searching is not just for rest
  • Extend _sort parameter
  • Add relevance score, and sorting by that
  • Remove the text parameter type, and add search parameters _text and _content
  • Add _profile parameter
  • Remove token modifiers :code and :anyns, and update documentation
  • Remove date modifiers and use < etc. Define escaping for search parameters
  • Change "integer" type to "number"
• /mailbox: allowed queries as well as messages and documents
• Terminologies: added several new terminologies, and changed the URI for SNOMED CT at the request of IHTSDO
• The following pages have been rewritten (Editorial changes only): "Resource Definitions", "Using codes" and the overview page
• Data Types:
  • Choice: remove choice and add Coding.valueset
  • CodeableConcept: move primary to Coding.primary
  • Coding: add primary, valueset and version & align code system version rules with core principles
  • Narrative: Changed the styles that can be used by authoring systems, and the obligations on rendering systems

1.4.1.2 Conformance Related Changes

• Document conformance rules more extensively
• Conformance:
  • Add Conformance.profile
  • Move system operations to rest.operations from rest.resource.operations, & add updateCreate and versionSpecificUpdates flags
  • Add note about Content-Location header
  • Add mailbox for documents profiles
• ValueSet:
  • add define.version
  • a new constraint that codes must be unique in the definition space
  • tighten up publication (maps and cross links, expansions, deal with poly-heirarchies & deprecated codes, publish all v3 code systems, map the data types)
  • add more uniqueness variants
  • tighten notes around imported value sets
• Profile:
  • Remove the concept of re-useable bindings, and collapse binding in line to element definition
  • Change definition.type.bundled to definition.type.aggregation, and add more invariants about uniqueness
  • Introduce a Map declaration element
• ConceptMap: added Informative ConceptMap resource
• Also, harmonize the search parameters for the metadata parts of Conformance, Profile, ValueSet, and ConceptMap

1.4.1.3 Resources

• General Changes:
  • Standardized identifiers: AdverseReaction, AllergyIntolerance, CarePlan, Condition, FamilyHistory, Procedure, Questionnaire all have identifier 0..*
  • Change the following fields from string|CodeableConcept to just CodeableConcept: Encounter.reason, MedicationDispense.dispense.dosage.additionalInstructions, MedicationPrescription.reasonForPrescribing, MedicationPrescription.dosageInstruction.additionalInstructions
• Alert:
  • improved the definitional documentation
• CarePlan:
  • made patient optional
  • reworked to link activities to goals and goals to concerns, and allow other resource kinds for activities
• Condition:
  • several changes around relatedItem
• Coverage:
  • resource has been removed
• Document:
  • Renamed the Document resource to "Composition"
  • revised status list per o-o analysis of reporting cycles
  • renamed sub-Type to "class" and updated definitions accordingly
  • changed the value set for confidentiality
  • changed the type of .replaces, and the code set for Document.status has changed
  • and made obligations around the handling of retracted documents more clear
  • Add Location as an allowed subject target
• DocumentManifest:
  • added this from scratch to round out XDS support
• DocumentReference:
  • aligned definitions more closely with XDS
  • Worked over the XDS Profile
  • Add _query=generate for DocumentReferences
  • Changed the value set for Confidentiality and format codes
• Encounter:
  • Allow RelatedPersons to be participants in an encounter and changed type of participation to CodeableConcept
  • Added discharge diagnosis to the Hospitalization element
• FamilyHistory:
  • change the value set for relation type to use the v3 value set directly
• ImagingStudy:
  • add link to DiagnosticOrder. Trim mappings to DICOM. Limit URL to WADO-RS only (not WADO)
• ImmunizationProfile:
  • rename to ImmunizationRecommendation
• Location:
  • Scope of Resource now also covers devices like freezers and incubators
  • Added a 'mode' to indicate Location instances or kinds
  • Split the existing element 'type' into 'type' (type of service provided) and 'physicalType' (physical form of the location)
  • A new 'status' element has replaced the boolean 'active', allowing for more values rather than true or false
  • Added 'identifier'
• Message:
  • rename the resource to "MessageHeader" and make the event code a Coding (also in the conformance statement too)
• Organization:
  • Can now refer to 0..* Locations where it provides services
• Patient:
  • Add Link structure to support typed, unidirectional links between Patient records
  • Added careProvider 0..* to express the nominated care providers, renamed "provider" to "managingOrganization"
  • Added a Patient link and unlink messages
• Practitioner:
  • Can now refer to 0..* Locations where the practitioner provides services
• Procedure:
  • made type a required element
  • changed type and cardinality for indications and complications
  • several changes around relatedItem
  • updated definition of procedure
• Questionnaire:
  • Added support for nested questions
  • new status codes
  • support for ordered answer values

1.4.1.4 Reference implementations

• Java: all changes as implied by above changes, and
  • todo
• C#: all changes as implied by above changes, and
  • Additional metadata attributes to facilitate validation, parsing and dynamic client/server behavior
  • Hl7.Fhir.Model dll now only contains the generated model classes. Parsing, serialization and client support has been moved out to a separate open-source library at http://github.com/ewoutkramer/fhir-net-api
• Pascal: all changes as implied by above changes, and
  • Fill out download with all dependent libraries
  • Release full server at http://github.com/grahamegrieve/fhirserver