This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
(v4.0.1:
R4
-
Mixed
Normative
and
STU
3).
)
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
R4
R3
R2
The
FHIR
specification
defines
a
set
of
resources,
and
an
infrastructure
for
handling
resources.
In
order
to
use
FHIR
to
create
solutions
for
integration
requirements,
implementers
must
map
their
problems
to
resources
and
their
content.
The
resources
are
classified
into
6
sections:
Clinical
:
The
content
Resource
List
provides
views
of
a
clinical
record
Identification
:
Supporting
entities
involved
in
the
care
process
Workflow
:
Manage
the
healthcare
process
Financial
:
Resources
that
support
the
billing
resources
organized
in
several
different
ways,
and
payment
parts
of
FHIR
Conformance
:
Resources
use
is
the
primary
entry
point
to
manage
specification,
development
and
testing
of
FHIR
solutions
Infrastructure
:
General
functionality,
and
resources
for
internal
FHIR
requirements
the
resources.
This
page
describes
the
resources
and
their
functional
intent
in
more
detail
to
assist
implementers
to
understand
their
purpose
and
scope,
and
their
supporting
classifications.
Where
to
find
common
concepts
in
this
specification:
Concept
Example
Where
to
find
Clinical
Findings
Laboratory
Results
Blood
panels
such
as
CBC
with
Differential,
Liver
Panel,
etc.
2.33.2.1
General
AllergyIntolerance
,
Condition
,
and
Procedure
are
common
resources
that
appear
throughout
the
patient
record
-
summaries
of
the
patient
status
or
history.
FamilyMemberHistory
tracks
significant
health
issues
for
relatives
of
the
patient,
since
these
are
significant
risk
factors
for
the
patient.
These
resources
may
be
found
in
patient,
episode,
discharge
summaries,
and
consultation
records.
ClinicalImpression
(aka
ClinicalAssessment)
records
the
core
of
a
clinical
consultation/assessment/impression.
When
a
single
text
note
is
inserted
directly
in
the
patient
record,
this
is
typically
a
ClinicalImpression.summary.
A
RiskAssessment
is
an
assessment
-
usually,
but
not
necessarily,
by
a
decision
support
engine
of
the
likely
outcomes
of
some
course
of
action
for
a
patient.
A
DetectedIssue
is
an
active
alert
that
there
is
a
clinical
issue
with/between
one
or
more
active
or
proposed
clinical
actions
for
a
patient.
One
way
it
may
be
used
is
as
part
of
an
error
message
in
response
to
an
attempted
operation.
Resource
Category
RIM
Lifecycle
AllergyIntolerance
Ongoing
Act
This
has
a
Current
List
Condition
Ongoing
Act
This
has
a
Current
List
Procedure
Past
Act
Clinical
Workflow
FamilyMemberHistory
Past
Act
ClinicalImpression
Past
Act
RiskAssessment
Present
Act
Clinical
Workflow
DetectedIssue
Present
Act
2.33.2.2
Care
Provision
These
resources
support
planning
of
care
provision
-
care
and
treatment
plans.
CarePlan
and
Goal
are
the
primary
structures
around
which
future
planning
for
the
patient
is
based.
These
are
used
to
define
care
and
treatment
planned
for
a
patient
in
the
future,
and
may
be
updated
and
adjusted
as
ongoing
care
is
provided.
ReferralRequest
is
the
basis
for
a
proposed/requested
transfer
of
care
from
one
clinician
to
another.
Typically,
these
are
associated
with
a
transfer
of
records,
and
a
physical
relocation
of
the
patient,
but
neither
of
these
are
required.
A
ProcedureRequest
records
a
request
for
a
procedure
to
be
carried
out.
NutritionOrder
is
a
request
to
supply
a
diet,
formula
feeding
(enteral)
or
oral
nutritional
supplement
to
a
patient
and
VisionPrescription
contains
the
details
of
visual
aids
requested
for
a
patient.
Resource
Category
RIM
Lifecycle
CarePlan
Ongoing
Act
Goal
Future
Act
Clinical
Workflow
ReferralRequest
Future
Act
Clinical
Workflow
ProcedureRequest
Future
Act
Clinical
Workflow
NutritionOrder
Future
/
Ongoing
Act
VisionPrescription
Future
Act
2.33.2.3
Medication
Management
Supports
the
medication
and
immunization
processes.
Some
points
of
note:
Prescription
=
a
MedicationRequest
In
some
records,
medication
orders,
administration,
and
statements
may
not
be
well
differentiated.
Generally,
use
MedicationStatement
if
records
are
unclear
A
medication
chart
(or
variants)
will
use
multiple
different
types
of
medication
resources
When
prescribing
is
done
by
an
external
system
(e.g.
most
ambulatory
e-prescribing),
the
Medication
resource
is
not
used.
It
is
generally
used
to
represent
information
in
formularies
and
to
describe
custom
formulations
Resource
Category
RIM
Lifecycle
Medication
Unrelated
Role
Medication
Medication
Act
Clinical
Workflow
MedicationDispense
Past
Act
Clinical
Workflow
MedicationRequest
Future
Act
Request/Order
.
This
has
a
current
List
MedicationStatement
Ongoing
/
Past
Act
Entity
Availability
Workflow
.
This
has
a
Current
List
Immunization
Past
Act
ImmunizationRecommendation
Future
Act
2.33.2.4
Diagnostics
Resources
concerned
with
observing
the
patient,
and
the
diagnostic
service
process
built
around
this.
The
Observation
resource
is
a
widely
used
general
purpose
tool.
Typical
uses
include
recording
the
following
kinds
of
data:
Laboratory
Results
Vital
Signs
(including
Blood
Pressure)
Physical
Examinations
Social
history
(e.g.
Smoking
History)
and
many
more
things
beside.
Note
that
'everything
is
an
observation',
but
implementations
should
not
use
Observation
where
Condition
is
more
appropriate.
ProcedureRequest
and
DiagnosticReport
support
the
overall
diagnostic
process.
A
DiagnosticReport
connects
the
process
of
'reporting',
linking
process
identifiers,
visual
presentations
of
a
report,
and
conclusions/interpretations
with
the
Observations.
ProcedureRequests
capture
the
request
from
an
authorized
clinician
to
initiate
the
diagnostic
process.
Specimen
and
BodySite
are
used
to
record
the
details
of
specimen
collection
although
BodySite
can
also
be
used
with
other
resources
(e.g.
Operation
location
details
on
a
Procedure).
The
resources
ImagingManifest
and
ImagingStudy
frameworks
are
provided
to
make
links
to
diagnostic
images
available
within
the
clinical
record,
where
the
actual
images
will
be
provided
by
dedicated
systems
(the
Media
resource
is
intended
for
sharing
actual
images
directly,
which
is
not
generally
suitable
for
high
resolution,
high
volume
diagnostic
images).
Resource
Category
RIM
Lifecycle
Observation
Past
Act
DiagnosticReport
Past
Act
Entity
Availability
Workflow
ProcedureRequest
Future
Act
Request/Order
Specimen
Unrelated
Role
Entity
Availability
Workflow
BodySite
Unrelated
Role
ImagingManifest
Past
Act
ImagingStudy
Past
Act
2.33.3
Administrative
Resources
These
resources
provide
support
for
identifying
the
various
entities
involved
in
healthcare:
people,
organizations,
substances,
devices,
etc.
2.33.3.1
Individuals
The
Patient
resource
represents
the
recipient
of
healthcare.
This
concept
is
not
always
referred
to
as
a
'patient'
-
other
words
such
as
client,
customer,
resident,
etc.
are
commonly
used,
but
in
this
specification,
the
recipient
of
healthcare
is
simply
known
as
the
patient.
The
patient
resource
includes
basic
demographics
and
next
of
kin
information.
The
Practitioner
resource
is
used
to
identify
and
describe
any
person
(or
even
animal)
involved
in
the
provision
of
care,
including
doctors,
nurses,
clerical
staff,
specialist
support
staff,
etc.
RelatedPerson
is
used
to
describe
individuals
who
are
related
helping
to
understand
the
patient
who
are
involved
in
the
healthcare
process,
beyond
merely
being
next
of
kin
-
they
may
sign
documents,
administer
medications,
be
the
source
of
information,
or
simply
provide
care
by
chance
at
an
accident.
Resource
Category
RIM
Lifecycle
Patient
Unrelated
Role
Entity
Availability
Workflow
Practitioner
Unrelated
Role
RelatedPerson
Unrelated
Role
2.33.3.2
Groups
In
most
provision
of
healthcare,
some
Organization
is
responsible
and
accountable
for
the
care,
and
references
appear
throughout
the
clinical
record.
The
organization
is
a
legal
entity
that
may
operate
at
multiple
locations.
A
HealthcareService
represents
the
services
offered
by
one
or
more
organizations
at
a
single
location.
A
Group
is
used
to
describe
one
or
more
individuals
-
usually
people,
though
other
kinds
of
entities
are
allowed.
Typically,
these
are
used
with
aggregate
reporting,
though
sometimes
care
is
provided
to
a
set
of
individuals
at
once
(some
counseling
procedures,
public
health
procedures,
herds
of
cattle,
etc.).
Resource
Category
RIM
Lifecycle
Organization
Unrelated
Role
HealthcareService
Unrelated
Role
Group
Unrelated
Entity
2.33.3.3
Entities
Location
-
for
where
things
happen.
Locations
are
either
by
instance
(e.g.
this
particular
room
at
a
given
address
or
GPS
coordinates)
or
by
kind
(e.g.
the
back
of
some
ambulance).
The
same
applies
to
Substance
,
for
some
kind
of
material
(e.g.
chemical)
used
in
healthcare
-
it
may
refer
to
an
identified
instance
(e.g.
bottle)
or
a
kind
of
chemical.
The
Person
resource
is
used
to
track
associations
between
different
patient
records
across
the
provision
of
healthcare
(e.g.
"master
patient
indexes").
Person
resources
are
not
referred
directly
from
other
resources;
their
use
is
for
dedicated
person
registries.
Resource
Category
RIM
Lifecycle
Location
Unrelated
Role
Entity
Availability
Workflow
Substance
Unrelated
Entity
Person
Unrelated
Entity
2.33.3.4
Device
Device
is
used
to
track
non-consumable
manufactured
materials
through
the
healthcare
process.
It
includes
implants,
large
instruments,
non-medical
things
(including
software),
and
containers.
Devices
-
and
therefore
the
device
resource
-
have
many
purposes,
including
stock
control,
locating
devices,
and
tracking
implants.
DeviceComponent
and
DeviceMetric
are
used
to
report
the
status
and
characteristics
of
the
kinds
of
medical
devices
that
produce
a
stream
of
one
or
more
data
points
(
Observations
),
usually
about
a
patient.
Resource
Category
RIM
Lifecycle
Device
Unrelated
Role
DeviceComponent
Unrelated
Role
DeviceMetric
Unrelated
Role
2.33.3.5
Research
ResearchStudy
is
used
to
capture
information
related
to
the
planning
and
execution
of
clinical
and
pre-clinical
studies.
It
covers
both
human
and
veterinary
studies
and
safety,
efficacy,
comparative
effectiveness
and
retrospective
trials.
ResearchSubject
capture
the
information
around
the
participation
of
a
specific
individual
(
Patient
)
provided
in
a
specific
ResearchStudy
.
This
information
includes
their
time
of
participation,
associated
study
arm,
status
within
the
study,
etc.
Resource
Category
RIM
Lifecycle
ResearchStudy
Unrelated
Act
ResearchSubject
Unrelated
Role
2.33.4
Work
Flow
2.33.4.1
Encounters
Encounter
tracks
an
interaction
between
a
patient
and
healthcare
provider(s).
Specifically,
this
resource
tracks
the
administrative
details
of
the
interaction,
not
the
clinical
details
(though
these
usual
link
to
it).
Aliases
for
this
include
'admission',
'consultation',
and
sometimes
'appointment'.
Encounters
may
be
nested
-
e.g.
when
the
patient
goes
to
physiotherapy
as
part
of
a
hospital
admission.
An
EpisodeOfCare
is
an
association
between
a
patient
and
a
care
provider
that
may
last
over
several
encounters.
The
purpose
of
EpisodeOfCare
is
track
a
provider
(person
or
organization)
that
has
an
interest
in
the
ongoing
care
of
the
patient.
A
Communication
is
a
record
of
a
formal
communication
with
a
patient
or
another
party
with
an
interest
in
their
care
-
a
letter,
email,
phone
call
etc.
A
Flag
is
warning
maintained
in
the
system
that
alerts
care
providers
to
potential
issues
they
should
be
aware
of
when
providing
care
to
a
patient,
or
at
a
location.
Resource
Category
RIM
Lifecycle
Encounter
Future
/
Ongoing
/
Past
Act
EpisodeOfCare
Act
Communication
Past
Act
Clinical
Workflow
Flag
Ongoing
Act
Entity
Availability
Workflow
2.33.4.2
Scheduling
These
resources
are
concerned
with
planning
times
and
locations
for
future
delivery
of
care:
specification:
A
Schedule
describes
a
set
of
times
in
the
future
that
a
service
or
individual
may
be
available
A
Slot
is
an
instance
of
a
time
in
a
schedule
that
may
be
reserved
An
Appointment
is
proposed
or
confirmed
future
event,
with
a
list
of
participants
who
may
or
may
not
have
confirmed
their
attendance
An
AppointmentResponse
is
an
individual's
acceptance
or
rejection
of
an
appointment
The
scheduling
systems
is
closely
aligned
with
the
iCal
system
so
that
systems
may
leverage
web
bookings
while
maintaining
integrity
with
the
rest
of
the
clinical
record.
Resource
Category
RIM
Lifecycle
Appointment
Future
Act
AppointmentResponse
Future
Act
Schedule
Future
Slot
Future
Act
2.33.4.3
Order
Management
Todo:
these
resources
are
all
draft.
Bringing
them
to
maturity
and
testing
their
support
for
real-world
scenarios
is
a
major
ongoing
focus
of
the
FHIR
project.
Resource
Category
RIM
Lifecycle
Task
Present
Act
CommunicationRequest
Future
Act
Request/Order
DeviceRequest
Present
Act
Request/Order
DeviceUseStatement
Past
Act
ProcessRequest
Present
Act
Request/Order
ProcessResponse
Present
Act
SupplyDelivery
Present
Act
SupplyRequest
Future
Act
2.33.5
Infrastructure
These
resources
provide
generally
useful
functionality,
and/or
are
referenced
directly
from
the
base
FHIR
framework
(
RESTful
API
,
messaging
,
documents
).
2.33.5.1
Information
Management
Questionnaire
and
QuestionnaireResponse
are
for
general
purpose
data
collection
from
a
patient
or
other
information
source.
They
represent
the
set
of
questions
to
be
answered,
and
an
individual's
responses
to
those
questions.
A
questionnaire
can
contain
any
kind
of
data,
including
the
data
represented
in
all
other
resources.
It
is
anticipated
that
the
data
will
be
processed
into
other
kinds
of
resources
for
further
usage
and
exchange.
The
Provenance
resource
is
used
to
make
statements
about
where
a
resource
came
from
-
that
is,
who,
what,
why,
when
and
where
for
its
creation.
This
may
be
used
in
assessing
the
integrity,
reliability
and
usefulness
of
a
resource
or
the
data
in
it.
Note
that
many
resources
contain
some
limited
amount
of
this
information
directly,
because
it
is
deemed
essential
to
using/finding/filtering/understanding
the
resource
directly.
Whenever
information
is
found
in
both
a
resource,
and
in
the
provenance
statements
for
the
resource,
it
is
expected
to
be
the
same.
An
AuditEvent
is
an
observation
by
a
system
that
a
record
was
altered
(created,
updated,
deleted)
or
otherwise
accessed
(queried,
transferred,
copied),
with
audit
information
about
the
event.
Typically,
the
provenance
record
is
created
before
the
resource
is
altered,
by
the
(sub)system
causing
the
change
to
the
resource,
while
the
audit
record
is
created
after
the
change
by
the
(sub)system
responsible
for
storing
it.
Resource
Category
RIM
Lifecycle
Questionnaire
Past
Act
QuestionnaireResponse
Past
Act
Provenance
Past
Act
AuditEvent
Past
Act
2.33.5.2
Documents
Modules
In
clinical
practice,
there
are
use
cases
for
both
exchanging
information
in
a
highly
granular
form,
and
for
exchanging
it
in
packages
known
as
'documents'.
This
specification
provides
two
different
kinds
of
support
for
creating
and
exchanging
documents:
Composition
allows
for
the
construction
of
a
detailed
document
package
using
other
resources
for
all
content
of
the
document
Subscription
allows
one
system
to
subscribe
to
events
on
another
system
Resource
Category
RIM
Lifecycle
MessageHeader
Present
Act
OperationOutcome
Present
Act
Parameters
Present
InfrastructureRoot
Subscription
Present
Act
2.33.6
Conformance
This
specification
is
a
base
platform
specification
that
defines
a
set
of
general
capabilities.
Specific
systems
build
on
top
of
that
to
create
interoperable
solutions
by
making
a
set
of
conformance
rules
.
These
conformance
rules
are
supported
by
a
this
set
of
"conformance"
resources.
2.33.6.1
Terminology
A
ValueSet
defines
a
set
of
codes
from
one
or
more
code
systems
that
are
used
for
validation,
lookup
etc.
A
ConceptMap
maps
value
sets
between
different
code
systems.
A
NamingSystem
resource
represents
an
external
provider
of
codes
or
identifiers
(e.g.
an
external
code
system
such
as
SNOMED
CT,
or
an
identification
system
such
as
an
institution
MRN).
The
naming
system
resource
exists
to
share
the
identification
and
registration
of
these
systems,
to
foster
consistency
in
their
identification.
Resource
Category
RIM
Lifecycle
ValueSet
Unrelated
ConceptMap
Unrelated
NamingSystem
Unrelated
2.33.6.2
Content
StructureDefinition
and
DataElement
both
describe
a
set
of
data
elements
that
can
represent
data
for
the
purposes
of
collection,
analysis
and
exchange.
They
have
slightly
different
purposes:
StructureDefinition
is
used
specifically
to
describe
the
structures
used
by
or
with
this
specification
DataElement
describes
more
general
data
items
that
are
represented
and
exchanged
in
many
formats
and/or
contexts
Mappings
(todo)
StructureMap
supports
a
general
purpose
mapping
language
that
can
be
used
to
transfer
data
from
one
structure
to
another.
Resource
Category
RIM
Lifecycle
StructureDefinition
Unrelated
StructureMap
Unrelated
Unrelated
DataElement
Unrelated
Entity
2.33.6.3
Behavior
A
CapabilityStatement
is
a
statement
of
a
set
of
system
capabilities
for
use
as
system
discovery,
or
conformance
expectations.
An
OperationDefinition
describes
an
operation
that
can
be
executed
on
a
server,
and
a
SearchParameter
defines
a
search
parameter
that
can
be
used
on
a
server.
CompartmentDefinition
provides
information
about
how
resources
are
associated
on
a
server.
MessageDefintion
describes
the
behavior
associated
with
receiving
a
particular
message.
Resource
Category
RIM
Lifecycle
CapabilityStatement
Unrelated
OperationDefinition
Unrelated
SearchParameter
Unrelated
CompartmentDefinition
Unrelated
2.33.6.4
Miscellaneous
ImplementationGuide
is
used
to
gather
all
the
other
resources
into
a
single
package
for
publication,
and
also
to
define
the
bounds
of
an
interoperability
solution.
A
TestScript
specifies
a
series
of
operations
and
outcomes
that
a
system
is
expected
to
meet.
TestScripts
are
for
development
and
acceptance
testing,
but
may
also
be
considered
for
use
with
production
systems,
if
the
tests
are
carefully
constructed
and
vetted.
A
TestReport
contains
the
test
execution
results
of
a
TestScript
against
a
series
of
operations
and
outcomes
that
a
system
is
expected
to
meet.
TestReports
provide
a
static
recording
of
TestScript
results
for
subsequent
retrieval
and
review..
Resource
Category
RIM
Lifecycle
ImplementationGuide
Unrelated
TestScript
Unrelated
TestReport
Unrelated
2.33.7
Financial
These
resources
are
all
in
draft
status
and
more
details
will
be
provided
here
in
due
course.
Resource
Category
RIM
Lifecycle
Coverage
Ongoing
Act
EligibilityRequest
Present
Act
EligibilityResponse
Present
Act
EnrollmentRequest
Present
Act
EnrollmentResponse
Present
Act
Claim
Present
Act
ClaimResponse
Present
Act
PaymentNotice
Past
Act
PaymentReconciliation
Past
Act
ExplanationOfBenefit
Past
Act
Foundation
.
Page
versions:
R5
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a
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