This
page
is
part
of
the
FHIR
Specification
(v5.0.0:
R5
-
STU
v6.0.0-ballot2:
Release
6
Ballot
(2nd
Draft)
(see
Ballot
Notes
).
This
is
the
The
current
published
version
in
it's
permanent
home
(it
will
always
be
available
at
this
URL).
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
R2
Implementable
Technology
Specifications
Work
Group
|
Maturity Level : Normative | Standards Status : Normative |
The
JSON
representation
for
a
resource
is
based
on
the
JSON
format
described
in
STD
90
(RFC
8259)
,
and
is
described
using
this
format:
{
"resourceType" : "[Resource Type]",
// from Source: property0
"property1" : "<[primitive]>", // short description
"property2" : { [Datatype] }, // short description
"property3" : { // Short Description
"propertyA" : { CodeableConcept }, // Short Description (Example)
},
"property4" : [{ // Short Description
"propertyB" : { Reference(ResourceType) } // R! Short Description
}]
}
Using this format:
property1
has
a
primitive
datatype;
the
value
of
the
property
will
be
as
described
for
the
stated
type
property2
has
a
complex
datatype;
the
value
of
the
property
is
an
object
that
has
the
content
as
described
for
the
stated
type
property3
is
an
object
property
that
contains
additional
properties
(e.g.
propertyA;
the
allowable
properties
are
listed,
and
also
include
extensions
as
appropriate)
property4
is
an
array
property
that
contains
items
which
are
objects
themselves.
The
items
may
have
any
of
the
types
already
encountered
in
points
1-3
propertyA
is
an
example
of
an
object
property
that
has
a
binding
to
a
value
set
-
the
Short
description
is
a
link
to
the
value
set.
In
addition,
the
binding
strength
is
shown
propertyB
is
an
example
of
an
object
property
that
has
a
reference
to
a
particular
kind
of
resource
//
is
used
for
comments.
While
//
is
legal
in
Javascript,
it
is
not
legal
in
JSON,
and
comments
SHALL
not
be
in
JSON
instances
irrespective
of
whether
particular
applications
ignore
them
application/fhir+json
.
Given the way extensions work, applications reading JSON resources will never encounter unknown properties. However, once an application starts trading with other applications that conform to later versions of this specification, unknown properties may be encountered. Applications MAY choose to ignore unknown properties in order to foster forwards compatibility in this regard, but may also choose not to.
This page contains some XML examples for the purposes of comparison between the two formats. The formats page has a comparison between the JSON and XML formats .
An
element
that
has
a
maximum
cardinality
of
>1
(e.g.
x..*
in
the
definitions)
may
occur
more
than
once
in
the
instance.
In
JSON,
this
is
done
by
using
an
array
type.
Note
that:
So a CodeableConcept is represented in JSON like this:
{
"coding": [
{
"system" : "http://snomed.info/sct",
"code" : "104934005"
},
{
"system" : "http://loinc.org",
"code" : "2947-0"
}
]
}
XML for comparison:
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="104934005"/>
</coding>
<coding>
<system value="http://loinc.org"/>
<code value="2947-0"/>
</coding>
</code>
FHIR elements with primitive datatypes are represented in two parts:
_
prepended
to
the
name
of
the
element,
which,
if
present,
contains
the
value's
id
and/or
extensions
The FHIR types integer , unsignedInt , positiveInt and decimal are represented as a JSON number, the FHIR type boolean as a JSON boolean, and all other types (including integer64 ) are represented as a JSON string which has the same content as that specified for the relevant datatype. Whitespace is always significant (i.e. no leading and trailing spaces for non-strings).
"code" : "abc", "birthDate" : "1972-11-30", "deceased" : false, "count" : 23 }
For comparison, this is represented in XML as
<code value="abc"/> <!-- code --> <birthDate value="1972-11-30"/> <!-- dateTime --> <deceased value="false" /> <!-- boolean --> <count value="23" /> <!-- integer -->
When
using
a
JavaScript
JSON.parse()
implementation,
note
that
JavaScript
natively
supports
only
one
numeric
datatype,
which
is
a
floating
point
number.
This
can
cause
loss
of
precision
for
FHIR
numbers.
In
particular,
trailing
0s
after
a
decimal
point
will
be
lost
e.g.
2.00
will
be
converted
to
2.
The
FHIR
decimal
datatype
is
defined
such
that
precision,
including
trailing
zeros,
is
preserved
for
presentation
purposes,
and
this
is
widely
regarded
as
critical
for
correct
presentation
of
clinical
measurements.
Implementations
should
consider
using
a
custom
parser
and
big
number
library
(e.g.
https://github.com/jtobey/javascript-bignum
)
to
meet
these
requirements.
See
also
the
precision
extension
.
If the value has an id attribute, or extensions, then this is represented as follows:
"birthDate": "1970-03-30",
"_birthDate": {
"id": "314159",
"extension" : [ {
"url" : "http://example.org/fhir/StructureDefinition/text",
"valueString" : "Easter 1970"
}]
}
Note:
If
the
primitive
has
an
id
attribute
or
extension,
but
no
value,
only
the
property
with
the
_
is
rendered.
This is represented in XML as:
<birthDate id="314159" value="1970-03-30" >
<extension url="http://example.org/fhir/StructureDefinition/text">
<valueString value="Easter 1970"/>
</extension>
</birthDate>
In the case where the primitive element may repeat, it is represented in two arrays. JSON null values are used to fill out both arrays so that the id and/or extension are aligned with the matching value in the first array, as demonstrated in this example:
<code value="au"/>
<code value="nz">
<extension url="http://hl7.org/fhir/StructureDefinition/display">
<valueString value="New Zealand a.k.a Kiwiland"/>
</extension>
</code>
is represented in JSON as:
"code": [ "au", "nz" ],
"_code": [
null,
{
"extension" : [ {
"url" : "http://hl7.org/fhir/StructureDefinition/display",
"valueString" : "New Zealand a.k.a Kiwiland"
}]
}
]
Note: when one of the repeating elements has no value, it is represented in the first array using a null. When an element has a value but no extension/id, the second array will have a null at the position of that element. If the length of a JSON "element" array is different from the length of its JSON "_element" array, implementations SHALL infer null values in the suffix of the shorter array. If an array has only null elements, implementations SHOULD omit it entirely.
Implementation Note: The representation of primitive datatypes has been split into two parts like this in order to simplify the representation of simple primitive values without id or extensions. This does have the cost of making the representation of the id attribute and extensions more ungainly, but these are both rarely used with primitive datatypes.
Complex datatypes (types that contain named elements of other types) are represented using a JSON object that contains a property for each element in the datatype. Complex datatypes can have ids, which are converted to JSON properties, in the same manner as described for primitives. For example:
<Patient>
<text>
<status value="generated" />
<div xmlns="http://www.w3.org/1999/xhtml"><p>...</p></div>
</text>
<name id="f2">
<use value="official" />
<given value="Karen" />
<family id="a2" value="Van" />
</name>
</Patient>
is represented in JSON as:
{
"resourceType" : "Patient",
"name" : [{
"id" : "f2",
"use" : "official" ,
"given" : [ "Karen" ],
"family" : "Van",
"_family" : {"id" : "a2"}
}],
"text" : {
"status" : "generated" ,
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>...</p></div>"
}
}
Things to note here are:
given
is
a
repeating
element,
so
it
is
serialized
as
an
Array,
whether
or
not
it
repeats
in
this
instance
name
,
the
id
is
added
represented
in
_family
as
described
above,
while
the
id
on
the
name
itself
is
represented
as
just
another
property
div
element
which
is
in
the
Narrative
element
text
is
represented
as
an
escaped
string
in
the
value
property
in
JSON.
The
xhtml
root
element
SHALL
be
a
<div>
in
the
xhtml
namespace
A
resource
is
a
JSON
object
with
a
property
resourceType
which
informs
the
parser
which
resource
type
this
is:
{
"resourceType" : "Patient",
"text" : {
"status" : "generated" ,
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>...</p></div>"
}
// etc...
}
Note that parsers cannot assume that the resourceType property will come first.
Implementation Note: This is a problem for several JSON -> Object serializers that assume that the resourceType property does come first, including Json.NET
. However, some JSON generators do not give the authoring application control of the order of the property values, and so these implementations cannot interoperate with implementations that make assumptions about order. Given that JSON says that the property values are an unordered map of name/value pairs, this specification cannot require that properties come in any particular order, though implementers may choose to fix the property order if they are able (and the reference platforms provided with this specification do so).
There is a sample file with many edge cases to help test JSON parsers.
Resources and/or Bundles may be digitally signed (see Bundle and Provenance ).
This specification defines the following method for canonicalizing FHIR resources, when represented as JSON. The signed set of fragments SHALL be transformed such that:
This
canonicalization
method
is
identified
by
the
URI
http://hl7.org/fhir/canonicalization/json
.
The
following
additional
canonicalization
URIs
are
also
defined:
| http://hl7.org/fhir/canonicalization/json#data |
The
narrative
(
Resource.text
)
is
omitted
prior
to
signing
(note
the
deletion
is
at
Resource.text
,
not
Resource.text.div
)
|
| http://hl7.org/fhir/canonicalization/json#static |
In
addition
to
narrative
(Resource.text),
the
Resource.meta
element
is
removed.
This
makes
the
signature
robust
as
the
content
is
moved
from
server
to
server,
or
workflow
and
access
tags
are
added
or
removed.
Note
that
workflow
and
security
tags
may
contain
information
important
to
the
handling
of
the
resource,
so
meta
elements
should
be
protected
from
tampering
by
other
means
if
unsigned.
|
| http://hl7.org/fhir/canonicalization/json#narrative |
This
method
only
retains
the
Resource.id
and
Narrative
elements
|
| http://hl7.org/fhir/canonicalization/json#document | The signs everything in a Bundle, except for the Bundle.id and Bundle.metadata on the root Bundle (allows for a document to be copied from server to server) |
These canonicalization methods allow system the flexibility to sign the various portions of the resource that matter for the workflow the signature serves. These canonicalization algorithms do not work for enveloped signatures. This will be researched and addressed in a future release. This specification may define additional canonicalizations in the future, and other specifications might also define additional canonicalization methods.
Implementation Note: One consequence of signing the document is that URLs, identifiers and internal references are frozen and cannot be changed. This might be a desired feature, but it may also cripple interoperability between closed ecosystems where re-identification frequently occurs. For this reason, it is recommended that systems consider carefully the impact of any signature processes. The impact of signatures on Document bundles and their related processes is the most well understood use of digital signatures.