Release 4 5 Ballot

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0-ballot: R5 Ballot - Mixed Normative and STU see ballot notes ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Operation-patient-everything

Example StructureDefinition/artifact-identifier (XML)

Patient Administration FHIR Infrastructure Work Group Maturity Level : N/A Standards Status : Informative Compartments : Patient , Practitioner , RelatedPerson
This is the narrative for the resource. See also the XML , JSON or Turtle format. Fetch Patient Record OPERATION: Fetch Patient Record The official URL for this operation definition is: http://hl7.org/fhir/OperationDefinition/Patient-everything This operation is used to return all the information related to one or more patients described in the resource or context on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the patient resource(s) itself is returned, along with any other resources that the server has that are related to the patient(s), and that are available for the given user. The server also returns whatever resources are needed to support the records - e.g. linked practitioners, medications, locations, organizations etc. The intended use for this operation is to provide a patient with access to their entire record (e.g. "Blue Button"), or for provider or other user to perform a bulk data download. The server SHOULD return at least all resources that it has that are in the patient compartment for the identified patient(s), and any resource referenced from those, including binaries and attachments. In the US Realm, at a minimum, the resources returned SHALL include all the data covered by the meaningful use common data elements as defined in the US Core Implementation Guide. Other applicable implementation guides may make additional rules about how much information that is returned. URL: [base]/Patient/$everything URL: [base]/Patient/[id]/$everything Parameters Use Name Cardinality Type Binding Documentation IN start 0..1
  • date Narrative The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no start date is provided, all records prior to the end date are in scope. IN end 0..1
  • date XML The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no end date is provided, all records subsequent to the start date are in scope. IN _since 0..1
  • instant JSON Resources updated after this period will be included in the response. The intent of this parameter is to allow a client to request only records that have changed since the last request, based on either the return header time, or or (for asynchronous use), the transaction time IN _type 0..*
  • code TTL

One or more parameters, each containing one or more comma-delimited FHIR resource types to include in the return resources. In the absence of any specified types, the server returns all resource types IN _count 0..1 integer Raw XML See discussion below on the utility of paging through the results of the $everything operation OUT return 1..1 Bundle ( canonical form The bundle type is "searchset" The key differences between this operation and simply searching the patient compartment are: unless the client requests otherwise, the server returns the entire result set in a single bundle (rather than using paging) the server is responsible for determining what resources to return as included resources (rather than the client specifying which ones). This frees the client from needing to determine what it could or should ask for, particularly with regard to included resources. Servers should consider returning appropriate Provenance and AuditTrail on the returned resources, even though these are not directly part of the patient compartment. It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a single patient, or determine whether the context has the rights to the nominated patient, if there is one, or can determine an appropriate list of patients to provide data for from the context of the request. If there is no nominated patient (GET /Patient/$everything) and the context is not associated with a single patient record, the actual list of patients is all patients that the user associated with the request has access to. This may be all patients in the family that the patient has access to, or it may be all patients that a care provider has access to, or all patients on the entire record system. In such cases, the server may choose to return an error rather than all the records. Specifying the relationship between the context, a user and patient records is outside the scope of this specification (though + also see The Smart App Launch Implementation Guide . When this operation is used to access multiple patient records at once, the return bundle could be rather a lot of data; servers may choose to require that such requests are made asynchronously , and associated with bulk data formats . Alternatively, clients may choose to page through the result set (or servers may require this). Paging through the results is done the same as for Searching , using the _count XML Format Specification parameter, and Bundle links. Implementers should note that paging will be slower than simply returning all the results at once (more network traffic, multiple latency delays) but may be required in order not to exhaust available memory reading or writing the whole response in a single package. Unlike searching, there is no inherent user-display order for the $everything operation. Servers might consider sorting the returned resources in descending order of last record update, but are not required to do so. )

The _since parameter is provided to support periodic queries to get additional information that has changed about the patient since the last query. This means that the _since parameter is based on record time. The value of the _since parameter should be set to the time from the server. If using direct response, this is the timestamp in the response header. If using the async interface, this is the transaction timestamp in the json response. Servers should ensure that the timestamps a managed such that the client does not miss any changes. Clients should be able to handle getting the same response more than once in the case that the transaction falls on a time boundary. Clients should ensure that the other query parameters are constant to ensure a coherent set of records when doing periodic queries. identifier 

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="artifact-identifier"/> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/artifact-identifier"/> 
  <version value="5.0.0-ballot"/> 
  <name value="identifier"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2022-02-07"/> 
  <publisher value="Health Level Seven, Inc. - CDS WG"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="HL7"/> 
    </telecom> 
  </contact> 
  <description value="A formal identifier that is used to identify this {{title}} when it is represented

   in other formats, or referenced in a specification, model, design or an instance."/> 
  <fhirVersion value="5.0.0-ballot"/> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <kind value="complex-type"/> 
  <abstract value="false"/> 
  <context> 
    <type value="element"/> 
    <expression value="Element"/> 
  </context> 
  <type value="Extension"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Extension">
      <path value="Extension"/> 
      <short value="Additional identifier for the {{title}}"/> 
      <definition value="A formal identifier that is used to identify this {{title}} when it is represented

       in other formats, or referenced in a specification, model, design or an instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)

       data type, and can then identify this {{title}} outside of FHIR, where it is not
       possible to use the logical URI."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
    </element> 
    <element id="Extension.id">
      <path value="Extension.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may

       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Extension.extension">
      <path value="Extension.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Extension.url">
      <path value="Extension.url"/> 
      <representation value="xmlAttr"/> 
      <short value="identifies the meaning of the extension"/> 
      <definition value="Source of the definition for the extension code - a logical name or a URL."/> 
      <comment value="The definition may point directly to a computable or human-readable definition

       of the extensibility codes, or it may be a logical URI as declared in some other
       specification. The definition SHALL be a URI for the Structure Definition defining
       the extension."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.url"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/artifact-identifier"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Extension.value[x]">
      <path value="Extension.value[x]"/> 
      <short value="Value of extension"/> 
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](

      extensibility.html) for a list)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="Extension">
      <path value="Extension"/> 
      <short value="Additional identifier for the {{title}}"/> 
      <definition value="A formal identifier that is used to identify this {{title}} when it is represented

       in other formats, or referenced in a specification, model, design or an instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)

       data type, and can then identify this {{title}} outside of FHIR, where it is not
       possible to use the logical URI."/> 
      <min value="0"/> 
      <max value="*"/> 
    </element> 
    <element id="Extension.extension">
      <path value="Extension.extension"/> 
      <max value="0"/> 
    </element> 
    <element id="Extension.url">
      <path value="Extension.url"/> 
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/artifact-identifier"/> 
    </element> 
    <element id="Extension.value[x]">
      <path value="Extension.value[x]"/> 
      <min value="1"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
    </element> 
  </differential> 

</

StructureDefinition

>
   

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.