5.17 Resource Group - Content

5.17.1 Scope and Usage

5.17.1.1 Use Cases

The group resource is used in one of two ways:

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

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

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

5.17.2 Boundaries and Relationships

There are five mechanisms in FHIR for communicating collections of resources:

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

• Structure
• UML
• XML
• JSON
• All

Structure

Name	Flags	Card.	Type	Description & Constraints
Group	I		DomainResource	Group of multiple entities Can only have members if group is "actual"
identifier	Σ	0..*	Identifier	Unique id
type	Σ	1..1	code	person | animal | practitioner | device | medication | substance GroupType (Required)
actual	Σ I	1..1	boolean	Descriptive or actual
code	Σ	0..1	CodeableConcept	Kind of Group members
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
characteristic		0..*	BackboneElement	Trait of group members
code		1..1	CodeableConcept	Kind of characteristic
value[x]		1..1		Value held by characteristic
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
exclude	?!	1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	I	0..*	BackboneElement	Who or what is in group
entity		1..1	Reference(Patient | Practitioner | Device | Medication | Substance)	Reference to the group member
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

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

{
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique id
  "type" : "<code>", // R!  person | animal | practitioner | device | medication | substance
  "actual" : <boolean>, // C? R!  Descriptive or actual
  "code" : { CodeableConcept }, // Kind of Group members
  "name" : "<string>", // Label for Group
  "quantity" : "<unsignedInt>", // Number of members
  "characteristic" : [{ // Trait of group members
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 4:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "period" : { Period } // Period over which characteristic is tested
  }],
  "member" : [{ // C? Who or what is in group
    "entity" : { Reference(Patient|Practitioner|Device|Medication|Substance) }, // R!  Reference to the group member
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}

Structure

Name	Flags	Card.	Type	Description & Constraints
Group	I		DomainResource	Group of multiple entities Can only have members if group is "actual"
identifier	Σ	0..*	Identifier	Unique id
type	Σ	1..1	code	person | animal | practitioner | device | medication | substance GroupType (Required)
actual	Σ I	1..1	boolean	Descriptive or actual
code	Σ	0..1	CodeableConcept	Kind of Group members
name	Σ	0..1	string	Label for Group
quantity	Σ	0..1	unsignedInt	Number of members
characteristic		0..*	BackboneElement	Trait of group members
code		1..1	CodeableConcept	Kind of characteristic
value[x]		1..1		Value held by characteristic
valueCodeableConcept			CodeableConcept
valueBoolean			boolean
valueQuantity			Quantity
valueRange			Range
exclude	?!	1..1	boolean	Group includes or excludes
period		0..1	Period	Period over which characteristic is tested
member	I	0..*	BackboneElement	Who or what is in group
entity		1..1	Reference(Patient | Practitioner | Device | Medication | Substance)	Reference to the group member
period		0..1	Period	Period member belonged to the group
inactive		0..1	boolean	If member is no longer in group
Documentation for this format

UML Diagram

XML Template

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

JSON Template

{
  "resourceType" : "Group",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique id
  "type" : "<code>", // R!  person | animal | practitioner | device | medication | substance
  "actual" : <boolean>, // C? R!  Descriptive or actual
  "code" : { CodeableConcept }, // Kind of Group members
  "name" : "<string>", // Label for Group
  "quantity" : "<unsignedInt>", // Number of members
  "characteristic" : [{ // Trait of group members
    "code" : { CodeableConcept }, // R!  Kind of characteristic
    // value[x]: Value held by characteristic. One of these 4:
    "valueCodeableConcept" : { CodeableConcept },
    "valueBoolean" : <boolean>,
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },
    "exclude" : <boolean>, // R!  Group includes or excludes
    "period" : { Period } // Period over which characteristic is tested
  }],
  "member" : [{ // C? Who or what is in group
    "entity" : { Reference(Patient|Practitioner|Device|Medication|Substance) }, // R!  Reference to the group member
    "period" : { Period }, // Period member belonged to the group
    "inactive" : <boolean> // If member is no longer in group
  }]
}