Data Exchange For Quality Measures STU3 for FHIR R4
3.0.0 - STU 3

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.0.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DEQMGapsInCareBundleProfile - XML Profile

XML representation of the gaps-bundle-deqm resource profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="gaps-bundle-deqm"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle">Bundle</a><a name="Bundle"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/bundle.html">Bundle</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Contains a collection of resources</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.type">type</a><a name="Bundle.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">document</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.entry">Slices for entry</a><a name="Bundle.entry"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Entry in the bundle - will have a resource or information</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by type:resource</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck035.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.entry:gaps_composition_entry" title="Slice gaps_composition_entry">entry:gaps_composition_entry</a><a name="Bundle.entry"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Contains a composition of gaps in care report for an individual for one or more measures</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0340.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.entry:gaps_composition_entry.resource">resource</a><a name="Bundle.entry.resource"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-gaps-composition-deqm.html" title="Composition">DEQMGapsInCareCompositionProfile</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">This Composition uses the DEQM Gaps In Care Composition Profile</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.entry:indv_measure_report_entry" title="Slice indv_measure_report_entry">entry:indv_measure_report_entry</a><a name="Bundle.entry"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Contains the individual MeasureReport referenced in the gaps in care composition<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-gaps-bundle-deqm-definitions.html#Bundle.entry:indv_measure_report_entry.resource">resource</a><a name="Bundle.entry.resource"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-indv-measurereport-deqm.html" title="MeasureReport">DEQMIndividualMeasureReportProfile</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">This MeasureReport uses the DEQM Individual MeasureReport Profile</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"/>
  <version value="3.0.0"/>
  <name value="DEQMGapsInCareBundleProfile"/>
  <title value="DEQM Gaps In Care Bundle Profile"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2021-04-23"/>
  <publisher value="HL7 International - Clinical Quality Information Work Group"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi/index.cfm"/>
    </telecom>
  </contact>
  <description
               value="The DEQM Gaps In Care Bundle Profile describes a bundle returned by the Measure [care-gaps](OperationDefinition-care-gaps.html) operation. This bundle consists of a document composition for gaps in care and supporting resources referenced by the composition."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="cda"/>
    <uri value="http://hl7.org/v3/cda"/>
    <name value="CDA (R2)"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Bundle"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Bundle">
      <path value="Bundle"/>
      <short value="Contains a collection of resources"/>
      <definition value="A container for a collection of resources."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="bdl-1"/>
        <severity value="error"/>
        <human value="total only when a search or history"/>
        <expression
                    value="total.empty() or (type = &#39;searchset&#39;) or (type = &#39;history&#39;)"/>
        <xpath
               value="not(f:total) or (f:type/@value = &#39;searchset&#39;) or (f:type/@value = &#39;history&#39;)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-2"/>
        <severity value="error"/>
        <human value="entry.search only when a search"/>
        <expression value="entry.search.empty() or (type = &#39;searchset&#39;)"/>
        <xpath
               value="not(f:entry/f:search) or (f:type/@value = &#39;searchset&#39;)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-3"/>
        <severity value="error"/>
        <human
               value="entry.request mandatory for batch/transaction/history, otherwise prohibited"/>
        <expression
                    value="entry.all(request.exists() = (%resource.type = &#39;batch&#39; or %resource.type = &#39;transaction&#39; or %resource.type = &#39;history&#39;))"/>
        <xpath
               value="not(f:entry/f:request) or (f:type/@value = &#39;batch&#39;) or (f:type/@value = &#39;transaction&#39;) or (f:type/@value = &#39;history&#39;)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-4"/>
        <severity value="error"/>
        <human
               value="entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited"/>
        <expression
                    value="entry.all(response.exists() = (%resource.type = &#39;batch-response&#39; or %resource.type = &#39;transaction-response&#39; or %resource.type = &#39;history&#39;))"/>
        <xpath
               value="not(f:entry/f:response) or (f:type/@value = &#39;batch-response&#39;) or (f:type/@value = &#39;transaction-response&#39;) or (f:type/@value = &#39;history&#39;)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-7"/>
        <severity value="error"/>
        <human
               value="FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)"/>
        <expression
                    value="(type = &#39;history&#39;) or entry.where(fullUrl.exists()).select(fullUrl&amp;resource.meta.versionId).isDistinct()"/>
        <xpath
               value="(f:type/@value = &#39;history&#39;) or (count(for $entry in f:entry[f:resource] return $entry[count(parent::f:Bundle/f:entry[f:fullUrl/@value=$entry/f:fullUrl/@value and ((not(f:resource/*/f:meta/f:versionId/@value) and not($entry/f:resource/*/f:meta/f:versionId/@value)) or f:resource/*/f:meta/f:versionId/@value=$entry/f:resource/*/f:meta/f:versionId/@value)])!=1])=0)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-9"/>
        <severity value="error"/>
        <human
               value="A document must have an identifier with a system and a value"/>
        <expression
                    value="type = &#39;document&#39; implies (identifier.system.exists() and identifier.value.exists())"/>
        <xpath
               value="not(f:type/@value = &#39;document&#39;) or exists(f:identifier/f:system) or exists(f:identifier/f:value)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-10"/>
        <severity value="error"/>
        <human value="A document must have a date"/>
        <expression
                    value="type = &#39;document&#39; implies (timestamp.hasValue())"/>
        <xpath
               value="not(f:type/@value = &#39;document&#39;) or exists(f:timestamp/@value)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-11"/>
        <severity value="error"/>
        <human value="A document must have a Composition as the first resource"/>
        <expression
                    value="type = &#39;document&#39; implies entry.first().resource.is(Composition)"/>
        <xpath
               value="not(f:type/@value=&#39;document&#39;) or f:entry[1]/f:resource/f:Composition"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-12"/>
        <severity value="error"/>
        <human value="A message must have a MessageHeader as the first resource"/>
        <expression
                    value="type = &#39;message&#39; implies entry.first().resource.is(MessageHeader)"/>
        <xpath
               value="not(f:type/@value=&#39;message&#39;) or f:entry[1]/f:resource/f:MessageHeader"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument, if bundle.type = document"/>
      </mapping>
    </element>
    <element id="Bundle.id">
      <path value="Bundle.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.meta">
      <path value="Bundle.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.implicitRules">
      <path value="Bundle.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="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."/>
      <comment
               value="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 it&#39;s narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.language">
      <path value="Bundle.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="Bundle.identifier">
      <path value="Bundle.identifier"/>
      <short value="Persistent identifier for the bundle"/>
      <definition
                  value="A persistent identifier for the bundle that won&#39;t change as a bundle is copied from server to server."/>
      <comment
               value="Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents  the .identifier SHALL be populated such that the .identifier is globally unique."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument.id"/>
      </mapping>
    </element>
    <element id="Bundle.type">
      <path value="Bundle.type"/>
      <short
             value="document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection"/>
      <definition
                  value="Indicates the purpose of this bundle - how it is intended to be used."/>
      <comment
               value="It&#39;s possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="document"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BundleType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Indicates the purpose of a bundle - how it is intended to be used."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/bundle-type|4.0.1"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
    </element>
    <element id="Bundle.timestamp">
      <path value="Bundle.timestamp"/>
      <short value="When the bundle was assembled"/>
      <definition
                  value="The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle."/>
      <comment
               value="For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.  

Usage:

* document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
* message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
* history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
* searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
* transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning

The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.timestamp"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.init"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument.effectiveTime"/>
      </mapping>
    </element>
    <element id="Bundle.total">
      <path value="Bundle.total"/>
      <short value="If search, the total number of matches"/>
      <definition
                  value="If a set of search matches, this is the total number of entries of type &#39;match&#39; across all pages in the search.  It does not include search.mode = &#39;include&#39; or &#39;outcome&#39; entries and it does not provide a count of the number of entries in the Bundle."/>
      <comment
               value="Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.total"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <condition value="bdl-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.link">
      <path value="Bundle.link"/>
      <short value="Links related to this Bundle"/>
      <definition value="A series of links that provide context to this bundle."/>
      <comment
               value="Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. [HATEOAS](http://en.wikipedia.org/wiki/HATEOAS)). 

Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was [read](http://hl7.org/fhir/R4/http.html#read) directly.

This specification defines some specific uses of Bundle.link for [searching](http://hl7.org/fhir/R4/search.html#conformance) and [paging](http://hl7.org/fhir/R4/http.html#paging), but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.link.id">
      <path value="Bundle.link.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.link.extension">
      <path value="Bundle.link.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.link.modifierExtension">
      <path value="Bundle.link.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.link.relation">
      <path value="Bundle.link.relation"/>
      <short
             value="See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1"/>
      <definition
                  value="A name which details the functional use for this link - see [http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1](http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.link.relation"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.link.url">
      <path value="Bundle.link.url"/>
      <short value="Reference details for the link"/>
      <definition value="The reference details for the link."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.link.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry">
      <path value="Bundle.entry"/>
      <slicing>
        <discriminator>
          <type value="type"/>
          <path value="resource"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="Entry in the bundle - will have a resource or information"/>
      <definition
                  value="An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only)."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Bundle.entry"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <orderMeaning
                    value="For bundles of type &#39;document&#39; and &#39;message&#39;, the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type"/>
      <constraint>
        <key value="bdl-5"/>
        <severity value="error"/>
        <human
               value="must be a resource unless there&#39;s a request or response"/>
        <expression
                    value="resource.exists() or request.exists() or response.exists()"/>
        <xpath
               value="exists(f:resource) or exists(f:request) or exists(f:response)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-8"/>
        <severity value="error"/>
        <human value="fullUrl cannot be a version specific reference"/>
        <expression value="fullUrl.contains(&#39;/_history/&#39;).not()"/>
        <xpath
               value="not(exists(f:fullUrl[contains(string(@value), &#39;/_history/&#39;)]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.id">
      <path value="Bundle.entry.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.extension">
      <path value="Bundle.entry.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.modifierExtension">
      <path value="Bundle.entry.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry.link">
      <path value="Bundle.entry.link"/>
      <short value="Links related to this entry"/>
      <definition value="A series of links that provide context to this entry."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle.entry.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <contentReference
                        value="http://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.fullUrl">
      <path value="Bundle.entry.fullUrl"/>
      <short
             value="URI for resource (Absolute URL server address or URI for UUID/OID)"/>
      <definition
                  value="The Absolute URL for the resource.  The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: 
* fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
* Results from operations might involve resources that are not identified."/>
      <comment
               value="fullUrl might not be [unique in the context of a resource](http://hl7.org/fhir/R4/bundle.html#bundle-unique). Note that since [FHIR resources do not need to be served through the FHIR API](http://hl7.org/fhir/R4/references.html), the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the [regex](http://hl7.org/fhir/R4/references.html#regex), then the &#39;id&#39; portion of the fullUrl SHALL end with the Resource.id.

Note that the fullUrl is not the same as the canonical URL - it&#39;s an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.fullUrl"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.resource">
      <path value="Bundle.entry.resource"/>
      <short value="A resource in the bundle"/>
      <definition
                  value="The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.resource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.search">
      <path value="Bundle.entry.search"/>
      <short value="Search related information"/>
      <definition
                  value="Information about the search process that lead to the creation of this entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-2"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.search.id">
      <path value="Bundle.entry.search.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.search.extension">
      <path value="Bundle.entry.search.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.search.modifierExtension">
      <path value="Bundle.entry.search.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry.search.mode">
      <path value="Bundle.entry.search.mode"/>
      <short value="match | include | outcome - why this is in the result set"/>
      <definition
                  value="Why this entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
      <comment
               value="There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, &#39;match&#39; takes precedence."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.mode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SearchEntryMode"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Why an entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry.search.score">
      <path value="Bundle.entry.search.score"/>
      <short value="Search ranking (between 0 and 1)"/>
      <definition
                  value="When searching, the server&#39;s search ranking score for the entry."/>
      <comment
               value="Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order.

See [Patient Match](http://hl7.org/fhir/R4/patient-operation-match.html) for the EMPI search which relates to this element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.score"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request">
      <path value="Bundle.entry.request"/>
      <short
             value="Additional execution information (transaction/batch/history)"/>
      <definition
                  value="Additional information about how this entry should be processed as part of a transaction or batch.  For history, it shows how the entry was processed to create the version contained in the entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-3"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request.id">
      <path value="Bundle.entry.request.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.request.extension">
      <path value="Bundle.entry.request.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.request.modifierExtension">
      <path value="Bundle.entry.request.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry.request.method">
      <path value="Bundle.entry.request.method"/>
      <short value="GET | HEAD | POST | PUT | DELETE | PATCH"/>
      <definition
                  value="In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.method"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="HTTPVerb"/>
        </extension>
        <strength value="required"/>
        <description
                     value="HTTP verbs (in the HTTP command line). See [HTTP rfc](https://tools.ietf.org/html/rfc7231) for details."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/http-verb|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry.request.url">
      <path value="Bundle.entry.request.url"/>
      <short value="URL for HTTP equivalent of this entry"/>
      <definition
                  value="The URL for this entry, relative to the root (the address to which the request is posted)."/>
      <comment
               value="E.g. for a Patient Create, the method would be &quot;POST&quot; and the URL would be &quot;Patient&quot;. For a Patient Update, the method would be PUT and the URL would be &quot;Patient/[id]&quot;."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request.ifNoneMatch">
      <path value="Bundle.entry.request.ifNoneMatch"/>
      <short value="For managing cache currency"/>
      <definition
                  value="If the ETag values match, return a 304 Not Modified status. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request.ifModifiedSince">
      <path value="Bundle.entry.request.ifModifiedSince"/>
      <short value="For managing cache currency"/>
      <definition
                  value="Only perform the operation if the last updated date matches. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifModifiedSince"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request.ifMatch">
      <path value="Bundle.entry.request.ifMatch"/>
      <short value="For managing update contention"/>
      <definition
                  value="Only perform the operation if the Etag value matches. For more information, see the API section [&quot;Managing Resource Contention&quot;](http://hl7.org/fhir/R4/http.html#concurrency)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.request.ifNoneExist">
      <path value="Bundle.entry.request.ifNoneExist"/>
      <short value="For conditional creates"/>
      <definition
                  value="Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for [&quot;Conditional Create&quot;](http://hl7.org/fhir/R4/http.html#ccreate). This is just the query portion of the URL - what follows the &quot;?&quot; (not including the &quot;?&quot;)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneExist"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response">
      <path value="Bundle.entry.response"/>
      <short value="Results of execution (transaction/batch/history)"/>
      <definition
                  value="Indicates the results of processing the corresponding &#39;request&#39; entry in the batch or transaction being responded to or what the results of an operation where when returning history."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-4"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response.id">
      <path value="Bundle.entry.response.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.response.extension">
      <path value="Bundle.entry.response.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry.response.modifierExtension">
      <path value="Bundle.entry.response.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry.response.status">
      <path value="Bundle.entry.response.status"/>
      <short value="Status response code (text optional)"/>
      <definition
                  value="The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response.location">
      <path value="Bundle.entry.response.location"/>
      <short value="The location (if the operation returns a location)"/>
      <definition
                  value="The location header created by processing this operation, populated if the operation returns a location."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response.etag">
      <path value="Bundle.entry.response.etag"/>
      <short value="The Etag for the resource (if relevant)"/>
      <definition
                  value="The Etag for the resource, if the operation for the entry produced a versioned resource (see [Resource Metadata and Versioning](http://hl7.org/fhir/R4/http.html#versioning) and [Managing Resource Contention](http://hl7.org/fhir/R4/http.html#concurrency))."/>
      <comment
               value="Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.etag"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response.lastModified">
      <path value="Bundle.entry.response.lastModified"/>
      <short value="Server&#39;s date time modified"/>
      <definition
                  value="The date/time that the resource was modified on the server."/>
      <comment
               value="This has to match the same time in the meta header (meta.lastUpdated) if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.lastModified"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry.response.outcome">
      <path value="Bundle.entry.response.outcome"/>
      <short
             value="OperationOutcome with hints and warnings (for batch/transaction)"/>
      <definition
                  value="An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction."/>
      <comment
               value="For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned.

This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry">
      <path value="Bundle.entry"/>
      <sliceName value="gaps_composition_entry"/>
      <short
             value="Contains a composition of gaps in care report for an individual for one or more measures"/>
      <definition
                  value="An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <orderMeaning
                    value="For bundles of type &#39;document&#39; and &#39;message&#39;, the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type"/>
      <constraint>
        <key value="bdl-5"/>
        <severity value="error"/>
        <human
               value="must be a resource unless there&#39;s a request or response"/>
        <expression
                    value="resource.exists() or request.exists() or response.exists()"/>
        <xpath
               value="exists(f:resource) or exists(f:request) or exists(f:response)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-8"/>
        <severity value="error"/>
        <human value="fullUrl cannot be a version specific reference"/>
        <expression value="fullUrl.contains(&#39;/_history/&#39;).not()"/>
        <xpath
               value="not(exists(f:fullUrl[contains(string(@value), &#39;/_history/&#39;)]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.id">
      <path value="Bundle.entry.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.extension">
      <path value="Bundle.entry.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.modifierExtension">
      <path value="Bundle.entry.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.link">
      <path value="Bundle.entry.link"/>
      <short value="Links related to this entry"/>
      <definition value="A series of links that provide context to this entry."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle.entry.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <contentReference
                        value="http://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.fullUrl">
      <path value="Bundle.entry.fullUrl"/>
      <short
             value="URI for resource (Absolute URL server address or URI for UUID/OID)"/>
      <definition
                  value="The Absolute URL for the resource.  The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: 
* fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
* Results from operations might involve resources that are not identified."/>
      <comment
               value="fullUrl might not be [unique in the context of a resource](http://hl7.org/fhir/R4/bundle.html#bundle-unique). Note that since [FHIR resources do not need to be served through the FHIR API](http://hl7.org/fhir/R4/references.html), the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the [regex](http://hl7.org/fhir/R4/references.html#regex), then the &#39;id&#39; portion of the fullUrl SHALL end with the Resource.id.

Note that the fullUrl is not the same as the canonical URL - it&#39;s an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.fullUrl"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.resource">
      <path value="Bundle.entry.resource"/>
      <short
             value="This Composition uses the DEQM Gaps In Care Composition Profile"/>
      <definition
                  value="A set of healthcare-related information that is assembled together into a single logical package 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. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.)."/>
      <comment
               value="While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.resource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Composition"/>
        <profile
                 value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"/>
      </type>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
        <expression
                    value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Document[classCode=&quot;DOC&quot; and moodCode=&quot;EVN&quot; and isNormalAct()]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument"/>
      </mapping>
      <mapping>
        <identity value="fhirdocumentreference"/>
        <map value="when described by DocumentReference"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search">
      <path value="Bundle.entry.search"/>
      <short value="Search related information"/>
      <definition
                  value="Information about the search process that lead to the creation of this entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-2"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search.id">
      <path value="Bundle.entry.search.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search.extension">
      <path value="Bundle.entry.search.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search.modifierExtension">
      <path value="Bundle.entry.search.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search.mode">
      <path value="Bundle.entry.search.mode"/>
      <short value="match | include | outcome - why this is in the result set"/>
      <definition
                  value="Why this entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
      <comment
               value="There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, &#39;match&#39; takes precedence."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.mode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SearchEntryMode"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Why an entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.search.score">
      <path value="Bundle.entry.search.score"/>
      <short value="Search ranking (between 0 and 1)"/>
      <definition
                  value="When searching, the server&#39;s search ranking score for the entry."/>
      <comment
               value="Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order.

See [Patient Match](http://hl7.org/fhir/R4/patient-operation-match.html) for the EMPI search which relates to this element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.score"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request">
      <path value="Bundle.entry.request"/>
      <short
             value="Additional execution information (transaction/batch/history)"/>
      <definition
                  value="Additional information about how this entry should be processed as part of a transaction or batch.  For history, it shows how the entry was processed to create the version contained in the entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-3"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.id">
      <path value="Bundle.entry.request.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.extension">
      <path value="Bundle.entry.request.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.modifierExtension">
      <path value="Bundle.entry.request.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.method">
      <path value="Bundle.entry.request.method"/>
      <short value="GET | HEAD | POST | PUT | DELETE | PATCH"/>
      <definition
                  value="In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.method"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="HTTPVerb"/>
        </extension>
        <strength value="required"/>
        <description
                     value="HTTP verbs (in the HTTP command line). See [HTTP rfc](https://tools.ietf.org/html/rfc7231) for details."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/http-verb|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.url">
      <path value="Bundle.entry.request.url"/>
      <short value="URL for HTTP equivalent of this entry"/>
      <definition
                  value="The URL for this entry, relative to the root (the address to which the request is posted)."/>
      <comment
               value="E.g. for a Patient Create, the method would be &quot;POST&quot; and the URL would be &quot;Patient&quot;. For a Patient Update, the method would be PUT and the URL would be &quot;Patient/[id]&quot;."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.ifNoneMatch">
      <path value="Bundle.entry.request.ifNoneMatch"/>
      <short value="For managing cache currency"/>
      <definition
                  value="If the ETag values match, return a 304 Not Modified status. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.ifModifiedSince">
      <path value="Bundle.entry.request.ifModifiedSince"/>
      <short value="For managing cache currency"/>
      <definition
                  value="Only perform the operation if the last updated date matches. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifModifiedSince"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.ifMatch">
      <path value="Bundle.entry.request.ifMatch"/>
      <short value="For managing update contention"/>
      <definition
                  value="Only perform the operation if the Etag value matches. For more information, see the API section [&quot;Managing Resource Contention&quot;](http://hl7.org/fhir/R4/http.html#concurrency)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.request.ifNoneExist">
      <path value="Bundle.entry.request.ifNoneExist"/>
      <short value="For conditional creates"/>
      <definition
                  value="Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for [&quot;Conditional Create&quot;](http://hl7.org/fhir/R4/http.html#ccreate). This is just the query portion of the URL - what follows the &quot;?&quot; (not including the &quot;?&quot;)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneExist"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response">
      <path value="Bundle.entry.response"/>
      <short value="Results of execution (transaction/batch/history)"/>
      <definition
                  value="Indicates the results of processing the corresponding &#39;request&#39; entry in the batch or transaction being responded to or what the results of an operation where when returning history."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-4"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.id">
      <path value="Bundle.entry.response.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.extension">
      <path value="Bundle.entry.response.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.modifierExtension">
      <path value="Bundle.entry.response.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.status">
      <path value="Bundle.entry.response.status"/>
      <short value="Status response code (text optional)"/>
      <definition
                  value="The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.location">
      <path value="Bundle.entry.response.location"/>
      <short value="The location (if the operation returns a location)"/>
      <definition
                  value="The location header created by processing this operation, populated if the operation returns a location."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.etag">
      <path value="Bundle.entry.response.etag"/>
      <short value="The Etag for the resource (if relevant)"/>
      <definition
                  value="The Etag for the resource, if the operation for the entry produced a versioned resource (see [Resource Metadata and Versioning](http://hl7.org/fhir/R4/http.html#versioning) and [Managing Resource Contention](http://hl7.org/fhir/R4/http.html#concurrency))."/>
      <comment
               value="Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.etag"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.lastModified">
      <path value="Bundle.entry.response.lastModified"/>
      <short value="Server&#39;s date time modified"/>
      <definition
                  value="The date/time that the resource was modified on the server."/>
      <comment
               value="This has to match the same time in the meta header (meta.lastUpdated) if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.lastModified"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.response.outcome">
      <path value="Bundle.entry.response.outcome"/>
      <short
             value="OperationOutcome with hints and warnings (for batch/transaction)"/>
      <definition
                  value="An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction."/>
      <comment
               value="For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned.

This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry">
      <path value="Bundle.entry"/>
      <sliceName value="indv_measure_report_entry"/>
      <short
             value="Contains the individual MeasureReport referenced in the gaps in care composition"/>
      <definition
                  value="An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle.entry"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <orderMeaning
                    value="For bundles of type &#39;document&#39; and &#39;message&#39;, the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type"/>
      <constraint>
        <key value="bdl-5"/>
        <severity value="error"/>
        <human
               value="must be a resource unless there&#39;s a request or response"/>
        <expression
                    value="resource.exists() or request.exists() or response.exists()"/>
        <xpath
               value="exists(f:resource) or exists(f:request) or exists(f:response)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="bdl-8"/>
        <severity value="error"/>
        <human value="fullUrl cannot be a version specific reference"/>
        <expression value="fullUrl.contains(&#39;/_history/&#39;).not()"/>
        <xpath
               value="not(exists(f:fullUrl[contains(string(@value), &#39;/_history/&#39;)]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.id">
      <path value="Bundle.entry.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.extension">
      <path value="Bundle.entry.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.modifierExtension">
      <path value="Bundle.entry.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.link">
      <path value="Bundle.entry.link"/>
      <short value="Links related to this entry"/>
      <definition value="A series of links that provide context to this entry."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Bundle.entry.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <contentReference
                        value="http://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.fullUrl">
      <path value="Bundle.entry.fullUrl"/>
      <short
             value="URI for resource (Absolute URL server address or URI for UUID/OID)"/>
      <definition
                  value="The Absolute URL for the resource.  The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that: 
* fullUrl can be empty on a POST (although it does not need to when specifying a temporary id for reference in the bundle)
* Results from operations might involve resources that are not identified."/>
      <comment
               value="fullUrl might not be [unique in the context of a resource](http://hl7.org/fhir/R4/bundle.html#bundle-unique). Note that since [FHIR resources do not need to be served through the FHIR API](http://hl7.org/fhir/R4/references.html), the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the [regex](http://hl7.org/fhir/R4/references.html#regex), then the &#39;id&#39; portion of the fullUrl SHALL end with the Resource.id.

Note that the fullUrl is not the same as the canonical URL - it&#39;s an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.fullUrl"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.resource">
      <path value="Bundle.entry.resource"/>
      <short
             value="This MeasureReport uses the DEQM Individual MeasureReport Profile"/>
      <definition
                  value="The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.resource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="MeasureReport"/>
        <profile
                 value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"/>
      </type>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
        <expression
                    value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="mrp-1"/>
        <severity value="error"/>
        <human
               value="Measure Reports used for data collection SHALL NOT communicate group and score information"/>
        <expression
                    value="(type != &#39;data-collection&#39;) or group.exists().not()"/>
        <xpath
               value="not(f:kind/@value=&#39;data-collection&#39;) or not(exists(f:group))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/MeasureReport"/>
      </constraint>
      <constraint>
        <key value="mrp-2"/>
        <severity value="error"/>
        <human
               value="Stratifiers SHALL be either a single criteria or a set of criteria components"/>
        <expression
                    value="group.stratifier.stratum.all(value.exists() xor component.exists())"/>
        <xpath
               value="not(f:kind/@value=&#39;data-collection&#39;) or not(exists(f:group))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/MeasureReport"/>
      </constraint>
      <constraint>
        <key value="deqm-2"/>
        <severity value="error"/>
        <human
               value="If the measure scoring type is &#39;proportion&#39;,&#39;ratio&#39;, or &#39;continuous-variable&#39; then the improvementNotation element is required"/>
        <expression
                    value="extension.(&#39;http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring&#39;).valueCodeableConcept.coding.code in (&#39;proportion&#39; | &#39;ratio&#39; | &#39;continuous-variable&#39;) implies improvementNotation.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.search">
      <path value="Bundle.entry.search"/>
      <short value="Search related information"/>
      <definition
                  value="Information about the search process that lead to the creation of this entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-2"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.search.id">
      <path value="Bundle.entry.search.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.search.extension">
      <path value="Bundle.entry.search.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Bundle.entry:indv_measure_report_entry.search.modifierExtension">
      <path value="Bundle.entry.search.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.search.mode">
      <path value="Bundle.entry.search.mode"/>
      <short value="match | include | outcome - why this is in the result set"/>
      <definition
                  value="Why this entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
      <comment
               value="There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, &#39;match&#39; takes precedence."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.mode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SearchEntryMode"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Why an entry is in the result set - whether it&#39;s included as a match or because of an _include requirement, or to convey information or warning information about the search process."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.search.score">
      <path value="Bundle.entry.search.score"/>
      <short value="Search ranking (between 0 and 1)"/>
      <definition
                  value="When searching, the server&#39;s search ranking score for the entry."/>
      <comment
               value="Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order.

See [Patient Match](http://hl7.org/fhir/R4/patient-operation-match.html) for the EMPI search which relates to this element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.search.score"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request">
      <path value="Bundle.entry.request"/>
      <short
             value="Additional execution information (transaction/batch/history)"/>
      <definition
                  value="Additional information about how this entry should be processed as part of a transaction or batch.  For history, it shows how the entry was processed to create the version contained in the entry."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-3"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.id">
      <path value="Bundle.entry.request.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.extension">
      <path value="Bundle.entry.request.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Bundle.entry:indv_measure_report_entry.request.modifierExtension">
      <path value="Bundle.entry.request.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.method">
      <path value="Bundle.entry.request.method"/>
      <short value="GET | HEAD | POST | PUT | DELETE | PATCH"/>
      <definition
                  value="In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.method"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="HTTPVerb"/>
        </extension>
        <strength value="required"/>
        <description
                     value="HTTP verbs (in the HTTP command line). See [HTTP rfc](https://tools.ietf.org/html/rfc7231) for details."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/http-verb|4.0.1"/>
      </binding>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.url">
      <path value="Bundle.entry.request.url"/>
      <short value="URL for HTTP equivalent of this entry"/>
      <definition
                  value="The URL for this entry, relative to the root (the address to which the request is posted)."/>
      <comment
               value="E.g. for a Patient Create, the method would be &quot;POST&quot; and the URL would be &quot;Patient&quot;. For a Patient Update, the method would be PUT and the URL would be &quot;Patient/[id]&quot;."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.ifNoneMatch">
      <path value="Bundle.entry.request.ifNoneMatch"/>
      <short value="For managing cache currency"/>
      <definition
                  value="If the ETag values match, return a 304 Not Modified status. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.ifModifiedSince">
      <path value="Bundle.entry.request.ifModifiedSince"/>
      <short value="For managing cache currency"/>
      <definition
                  value="Only perform the operation if the last updated date matches. See the API documentation for [&quot;Conditional Read&quot;](http://hl7.org/fhir/R4/http.html#cread)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifModifiedSince"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.ifMatch">
      <path value="Bundle.entry.request.ifMatch"/>
      <short value="For managing update contention"/>
      <definition
                  value="Only perform the operation if the Etag value matches. For more information, see the API section [&quot;Managing Resource Contention&quot;](http://hl7.org/fhir/R4/http.html#concurrency)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifMatch"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.request.ifNoneExist">
      <path value="Bundle.entry.request.ifNoneExist"/>
      <short value="For conditional creates"/>
      <definition
                  value="Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for [&quot;Conditional Create&quot;](http://hl7.org/fhir/R4/http.html#ccreate). This is just the query portion of the URL - what follows the &quot;?&quot; (not including the &quot;?&quot;)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.request.ifNoneExist"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response">
      <path value="Bundle.entry.response"/>
      <short value="Results of execution (transaction/batch/history)"/>
      <definition
                  value="Indicates the results of processing the corresponding &#39;request&#39; entry in the batch or transaction being responded to or what the results of an operation where when returning history."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="bdl-4"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.id">
      <path value="Bundle.entry.response.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.extension">
      <path value="Bundle.entry.response.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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 manageable, 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Bundle.entry:indv_measure_report_entry.response.modifierExtension">
      <path value="Bundle.entry.response.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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&#39;s descendants. Usually modifier elements provide negation or qualification. 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 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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.status">
      <path value="Bundle.entry.response.status"/>
      <short value="Status response code (text optional)"/>
      <definition
                  value="The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.location">
      <path value="Bundle.entry.response.location"/>
      <short value="The location (if the operation returns a location)"/>
      <definition
                  value="The location header created by processing this operation, populated if the operation returns a location."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.etag">
      <path value="Bundle.entry.response.etag"/>
      <short value="The Etag for the resource (if relevant)"/>
      <definition
                  value="The Etag for the resource, if the operation for the entry produced a versioned resource (see [Resource Metadata and Versioning](http://hl7.org/fhir/R4/http.html#versioning) and [Managing Resource Contention](http://hl7.org/fhir/R4/http.html#concurrency))."/>
      <comment
               value="Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.etag"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.lastModified">
      <path value="Bundle.entry.response.lastModified"/>
      <short value="Server&#39;s date time modified"/>
      <definition
                  value="The date/time that the resource was modified on the server."/>
      <comment
               value="This has to match the same time in the meta header (meta.lastUpdated) if a resource is included."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.lastModified"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.response.outcome">
      <path value="Bundle.entry.response.outcome"/>
      <short
             value="OperationOutcome with hints and warnings (for batch/transaction)"/>
      <definition
                  value="An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction."/>
      <comment
               value="For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned.

This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.entry.response.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Bundle.signature">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use"/>
      </extension>
      <path value="Bundle.signature"/>
      <short value="Digital Signature"/>
      <definition value="Digital Signature - base64 encoded. XML-DSig or a JWT."/>
      <comment
               value="The signature could be created by the &quot;author&quot; of the bundle or by the originating device.   Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific."/>
      <requirements
                    value="A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Bundle.signature"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Signature"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
  </snapshot>
  <differential>
    <element id="Bundle">
      <path value="Bundle"/>
    </element>
    <element id="Bundle.type">
      <path value="Bundle.type"/>
      <fixedCode value="document"/>
    </element>
    <element id="Bundle.entry">
      <path value="Bundle.entry"/>
      <slicing>
        <discriminator>
          <type value="type"/>
          <path value="resource"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry">
      <path value="Bundle.entry"/>
      <sliceName value="gaps_composition_entry"/>
      <short
             value="Contains a composition of gaps in care report for an individual for one or more measures"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Bundle.entry:gaps_composition_entry.resource">
      <path value="Bundle.entry.resource"/>
      <short
             value="This Composition uses the DEQM Gaps In Care Composition Profile"/>
      <min value="1"/>
      <type>
        <code value="Composition"/>
        <profile
                 value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry">
      <path value="Bundle.entry"/>
      <sliceName value="indv_measure_report_entry"/>
      <short
             value="Contains the individual MeasureReport referenced in the gaps in care composition"/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
    </element>
    <element id="Bundle.entry:indv_measure_report_entry.resource">
      <path value="Bundle.entry.resource"/>
      <short
             value="This MeasureReport uses the DEQM Individual MeasureReport Profile"/>
      <min value="1"/>
      <type>
        <code value="MeasureReport"/>
        <profile
                 value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"/>
      </type>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>