The US-PCS only profiles seven sections in the US-PCS Composition. This Bundle profile only includes resources from those seven sections, even though other resources could be used for other sections. This does not exclude other resources due to the open slicing of Bundle.entry. For the organization of which resources to include in each section, refer to the US-PCS Composition profile.

The US-PCS does not profile Bundle.signature for document signatures since emerging FHIR guidance has favored usage of Provenance.signature. We recommend implementers refer to the latest FHIR guidance when including signatures on attested US-PCS documents and content.

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system and handled by the receiving system (see US-PCS Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and the formal summary, and definitions then follow.

Each US-PCS Bundle Must Have:

1. an identifier
2. a type specifying that it is a document
3. a timestamp
4. a US-PCS Composition
5. a US Core Patient

Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US-PCS Profile.

• Senders are expected to include more than just the required US-PCS Composition and US Core Patient resources. The US-PCS Composition profiles seven specific sections, which is a subset of the sections available in the IPS FHIR Implementation Guide. Systems are allowed to extend beyond what is included in this profile, or IPS, to support a more comprehensive patient summary.

• All entries in the Bundle SHALL include a fullUrl, and a resource.^§bund-1

• All entries in the Bundle SHALL NOT include: any Composition resource other than the first, a search attribute, a request attribute, or a response attribute.^§bund-2

The US-PCS General Guidance page includes the definition of Must Support for this guide and additional guidance on populating sections.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, clindoc-timestamp-ge-compoDate, bdl-uspcs-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
identifier	SΣ	1..1	Identifier	Persistent identifier for the bundle
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	Identifier system+value must be globally unique Example General: 123456
type	SΣ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: document
timestamp	SΣ	1..1	instant	When the bundle was assembled
Slices for entry	SΣC	2..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:$this.resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:clinical-document-composition	SΣC	1..1	BackboneElement	First entry is a composition Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:patient.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:condition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:organization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()
clindoc-timestamp-ge-compoDate	error	Bundle	For a FHIR Clinical Document the Bundle timestamp must be the same or after the Composition date	timestamp >= entry.first().resource.date
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-uspcs-1
entry		2..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
Slices for entry				Content/Rules for all slices
entry:clinical-document-composition	S	1..1	BackboneElement	First entry is a composition
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	S	1..1	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, clindoc-timestamp-ge-compoDate, bdl-uspcs-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	SΣ	1..1	Identifier	Persistent identifier for the bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	Identifier system+value must be globally unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
type	SΣ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: document
timestamp	SΣ	1..1	instant	When the bundle was assembled
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	SΣC	2..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:$this.resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:clinical-document-composition	SΣC	1..1	BackboneElement	First entry is a composition Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
signature	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Bundle.identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Bundle.identifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.search.​mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:patient.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:patient.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:condition.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:condition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:organization.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:organization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()
clindoc-timestamp-ge-compoDate	error	Bundle	For a FHIR Clinical Document the Bundle timestamp must be the same or after the Composition date	timestamp >= entry.first().resource.date
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, clindoc-timestamp-ge-compoDate, bdl-uspcs-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
identifier	SΣ	1..1	Identifier	Persistent identifier for the bundle
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	Identifier system+value must be globally unique Example General: 123456
type	SΣ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: document
timestamp	SΣ	1..1	instant	When the bundle was assembled
Slices for entry	SΣC	2..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:$this.resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:clinical-document-composition	SΣC	1..1	BackboneElement	First entry is a composition Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:patient.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:condition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:organization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()
clindoc-timestamp-ge-compoDate	error	Bundle	For a FHIR Clinical Document the Bundle timestamp must be the same or after the Composition date	timestamp >= entry.first().resource.date
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-uspcs-1
entry		2..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
Slices for entry				Content/Rules for all slices
entry:clinical-document-composition	S	1..1	BackboneElement	First entry is a composition
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	S	1..1	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization		0..*	BackboneElement	Entry in the bundle - will have a resource or information
fullUrl	S	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	ClinicalDocumentBundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, clindoc-timestamp-ge-compoDate, bdl-uspcs-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	SΣ	1..1	Identifier	Persistent identifier for the bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	Identifier system+value must be globally unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
type	SΣ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Required Pattern: document
timestamp	SΣ	1..1	instant	When the bundle was assembled
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	SΣC	2..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:$this.resource Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	SΣ	1..1	Resource	A resource in the bundle
entry:clinical-document-composition	SΣC	1..1	BackboneElement	First entry is a composition Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	CompositionUsPcs	US-PCS Composition
entry:patient	SΣC	1..1	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePatientProfile	Information about an individual or animal receiving health care services
entry:allergyintolerance	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreAllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
entry:condition	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreConditionProblemsHealthConcernsProfile	Detailed information about conditions, problems or diagnoses
entry:diagnosticreport	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreDiagnosticReportProfileLaboratoryReporting, USCoreDiagnosticReportProfileNoteExchange	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
entry:encounter	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreEncounterProfile	An interaction during which services are provided to the patient
entry:immunization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreImmunizationProfile	Immunization event information
entry:medicationrequest	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreMedicationRequestProfile	Ordering of medication for patient or group
entry:practitioner	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCorePractitionerProfile	A person with a formal responsibility in the provisioning of healthcare or related services
entry:procedure	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreProcedureProfile	An action that is being or was performed on a patient
entry:observation-results	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	Observation, USCoreObservationClinicalResultProfile, USCoreLaboratoryResultObservationProfile	Measurements and simple assertions
entry:organization	SΣC	0..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', 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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	SΣ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	S	1..1	USCoreOrganizationProfile	A grouping of people or organizations with a common purpose
signature	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Bundle.identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Bundle.identifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.search.​mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:clinical-document-composition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:patient.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:patient.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:allergyintolerance.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:condition.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:condition.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:diagnosticreport.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:encounter.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:immunization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:medicationrequest.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:practitioner.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:procedure.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:observation-results.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.
Bundle.entry:organization.​search.mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry:organization.​request.method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry, Bundle.entry:clinical-document-composition, Bundle.entry:patient, Bundle.entry:allergyintolerance, Bundle.entry:condition, Bundle.entry:diagnosticreport, Bundle.entry:encounter, Bundle.entry:immunization, Bundle.entry:medicationrequest, Bundle.entry:practitioner, Bundle.entry:procedure, Bundle.entry:observation-results, Bundle.entry:organization	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
bdl-uspcs-1	error	Bundle	A US-PCS document must have no additional Composition (including Composition subclass) resources besides the first.	entry.tail().where(resource is Composition).empty()
clindoc-timestamp-ge-compoDate	error	Bundle	For a FHIR Clinical Document the Bundle timestamp must be the same or after the Composition date	timestamp >= entry.first().resource.date
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Mandatory: 4 elements(10 nested mandatory elements)
Must-Support: 27 elements

Structures

This structure refers to these other structures:

• Composition (US-PCS) (http://hl7.org/fhir/us/pcs/StructureDefinition/Composition-us-pcs)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core AllergyIntolerance Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance)
• US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns)
• US Core DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab)
• US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note)
• US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)
• US Core Immunization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization)
• US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core Procedure Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure)
• US Core Observation Clinical Result Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result)
• US Core Laboratory Result Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Maturity: 2