Data Exchange For Quality Measures Implementation Guide
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## Resource Profile: DEQM Gaps In Care Bundle

Official URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarebundle | Version: 1.0.0-ballot | Highlight text changes?
Standards status: Trial-use Active as of 2026-04-07 | Maturity Level: 4 | Computable Name: DEQMGapsInCareBundle

The DEQM Gaps In Care Bundle describes a bundle returned by the Measure care-gaps operation. This bundle consists of a document composition for gaps in care and supporting resources referenced by the composition.

### Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each Bundle Must Have:

1. type: document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
2. identifier.system: The namespace for the identifier value
3. timestamp: When the bundle was assembled
4. identifier: Persistent identifier for the bundle
5. identifier.value: The value that is unique

Each Bundle Must Support:

1. entry: Contains a composition of gaps in care report for an individual for one or more measures

This profile builds on Bundle.

Additional Profile specific implementation guidance:

Conformance Requirement 1:

The DEQM Gaps In Care Bundle SHALL include entries for all patient specific resources including evaluated resources referenced by the included DEQM Gaps In Care MeasureReport and for resources referenced by the DEQM Gaps In Care DetectedIssue including GuidanceResponse.

Usages:

- Examples for this Profile: Bundle/non-document-gaps-in-care, Bundle/single-gaps-closed-indv-report01, Bundle/single-gaps-closed-indv-report02 and Bundle/single-gaps-open-indv-report01
- CapabilityStatements using this Profile: Gaps In Care Client CapabilityStatement and Gaps In Care Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
identifier | S Σ | 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 | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
type | S Σ | 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.
timestamp | S Σ | 1..1 | instant | When the bundle was assembled
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type: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
entry:gaps-composition-deqm | S Σ C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: bdl-5, bdl-8, gic-1, gic-2 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
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
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.

#### 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:gaps-composition-deqm | 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:gaps-composition-deqm | 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)`
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()`
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle |  | 0..* | Bundle | Contains a collection of resources
identifier | S | 1..1 | Identifier | Persistent identifier for the bundle
system | S | 1..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
type | S | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
timestamp | S | 1..1 | instant | When the bundle was assembled
Slices for entry | S | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:gaps-composition-deqm | S C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: gic-1, gic-2
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
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 | S Σ | 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 | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is 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 | S Σ | 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.
timestamp | S Σ | 1..1 | instant | When the bundle was assembled
total | Σ C | 0..1 | unsignedInt | If search, the total number of matches
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 | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type: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 | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | Σ | 0..1 | Resource | A resource in the bundle
search | Σ C | 0..1 | BackboneElement | Search related information
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
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
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
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
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
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:gaps-composition-deqm | S Σ C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: bdl-5, bdl-8, gic-1, gic-2 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 | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
search | Σ C | 0..1 | BackboneElement | Search related information
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
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
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
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
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
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
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:gaps-composition-deqm.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:gaps-composition-deqm.​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:gaps-composition-deqm | 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:gaps-composition-deqm | 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)`
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()`
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Summary

Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- DEQM Gaps In Care Composition Profile (http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Bundle.entry

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
identifier | S Σ | 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 | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
type | S Σ | 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.
timestamp | S Σ | 1..1 | instant | When the bundle was assembled
Slices for entry | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type: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
entry:gaps-composition-deqm | S Σ C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: bdl-5, bdl-8, gic-1, gic-2 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
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
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.

#### 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:gaps-composition-deqm | 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:gaps-composition-deqm | 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)`
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()`
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle |  | 0..* | Bundle | Contains a collection of resources
identifier | S | 1..1 | Identifier | Persistent identifier for the bundle
system | S | 1..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
type | S | 1..1 | code | document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
timestamp | S | 1..1 | instant | When the bundle was assembled
Slices for entry | S | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:gaps-composition-deqm | S C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: gic-1, gic-2
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Bundle | C | 0..* | Bundle | Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
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 | S Σ | 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 | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is 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 | S Σ | 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.
timestamp | S Σ | 1..1 | instant | When the bundle was assembled
total | Σ C | 0..1 | unsignedInt | If search, the total number of matches
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 | S Σ C | 1..* | BackboneElement | Entry in the bundle - will have a resource or information Slice: Unordered, Open by type: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 | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | Σ | 0..1 | Resource | A resource in the bundle
search | Σ C | 0..1 | BackboneElement | Search related information
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
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
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
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
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
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
entry:gaps-composition-deqm | S Σ C | 0..1 | BackboneElement | Contains a composition of gaps in care report for an individual for one or more measures Constraints: bdl-5, bdl-8, gic-1, gic-2 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 | Σ | 0..1 | uri | URI for resource (Absolute URL server address or URI for UUID/OID)
resource | S | 1..1 | DEQMGapsInCareComposition | This Composition uses the DEQM Gaps In Care Composition Profile
search | Σ C | 0..1 | BackboneElement | Search related information
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
mode | Σ | 0..1 | code | match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score | Σ | 0..1 | decimal | Search ranking (between 0 and 1)
request | Σ C | 0..1 | BackboneElement | Additional execution information (transaction/batch/history)
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
method | Σ | 1..1 | code | GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url | Σ | 1..1 | uri | URL for HTTP equivalent of this entry
ifNoneMatch | Σ | 0..1 | string | For managing cache currency
ifModifiedSince | Σ | 0..1 | instant | For managing cache currency
ifMatch | Σ | 0..1 | string | For managing update contention
ifNoneExist | Σ | 0..1 | string | For conditional creates
response | Σ C | 0..1 | BackboneElement | Results of execution (transaction/batch/history)
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
status | Σ | 1..1 | string | Status response code (text optional)
location | Σ | 0..1 | uri | The location (if the operation returns a location)
etag | Σ | 0..1 | string | The Etag for the resource (if relevant)
lastModified | Σ | 0..1 | instant | Server's date time modified
outcome | Σ | 0..1 | Resource | OperationOutcome with hints and warnings (for batch/transaction)
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:gaps-composition-deqm.​search.mode | Base | required | SearchEntryMode | 📍4.0.1 | FHIR Std.
Bundle.entry:gaps-composition-deqm.​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:gaps-composition-deqm | 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:gaps-composition-deqm | 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)`
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()`
gic-1 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is present, then Bundle.type is 'document' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition') implies %resource.type='document'`
gic-2 | error | Bundle.entry:gaps-composition-deqm | if 'entry:gaps-composition-deqm' is not present, then Bundle.type is 'collection' | `resource.meta.profile.contains('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition').not() implies %resource.type='collection'`

Summary

Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- DEQM Gaps In Care Composition Profile (http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-gapsincarecomposition)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Bundle.entry

Maturity: 4

Other representations of profile: CSV, Excel, Schematron