HL7 Europe Imaging Study Report
0.1.0-ballot - ci-build 150

HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/tree/master and changes regularly. See the Directory of published versions

Resource Profile: Manifest_EuEndpoint - Detailed Descriptions

Draft as of 2025-07-02

Definitions for the Manifest-EuEndpoint resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Endpoint
Definition

The technical details of an endpoint that can be used for electronic services, such as for web services providing XDS.b, a REST endpoint for another FHIR server, or a s/Mime email address. This may include any security context information.

ShortThe technical details of an endpoint that can be used for electronic services
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Endpoint.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Endpoint.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Endpoint.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Endpoint.identifier
Definition

Identifier for the organization that is used to identify the endpoint across multiple disparate systems.

ShortIdentifies this endpoint across multiple systems
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Obligations
    ObligationsActorDocumentation
    SHALL:populate-if-knownImaging study manifest provider

    EHDSEndpoint.identifier

    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Endpoint.status
    Definition

    The endpoint status represents the general expected availability of an endpoint.

    Shortactive | suspended | error | off | entered-in-error | test
    Comments

    This element is labeled as a modifier because the status contains codes that mark the endpoint as not currently valid. Temporary downtimes or other unexpected short-term changes in availability would not be represented in this property.

    Control1..1
    BindingThe codes SHALL be taken from EndpointStatushttp://hl7.org/fhir/ValueSet/endpoint-status|5.0.0
    (required to http://hl7.org/fhir/ValueSet/endpoint-status|5.0.0)

    The status of the endpoint.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Obligations
      ObligationsActorDocumentation
      SHALL:populate-if-knownImaging study manifest provider

      EHDSEndpoint.status

      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Endpoint.connectionType
      Definition

      A coded value that represents the technical details of the usage of this endpoint, such as what WSDLs should be used in what way. (e.g. XDS.b/DICOM/cds-hook).

      ShortProtocol/Profile/Standard to be used with this endpoint connection
      Comments

      For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example. If there are multiple payload types or mimetypes they are all applicable for all connection types, and all have the same status.

      Control1..*
      BindingFor example codes, see EndpointConnectionTypehttp://hl7.org/fhir/ValueSet/endpoint-connection-type
      (example to http://hl7.org/fhir/ValueSet/endpoint-connection-type)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Obligations
        ObligationsActorDocumentation
        SHALL:populate-if-knownImaging study manifest provider

        EHDSEndpoint.connectionType

        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. Endpoint.name
        Definition

        A friendly name that this endpoint can be referred to with.

        ShortA name that this endpoint can be identified by
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Obligations
          ObligationsActorDocumentation
          SHALL:populate-if-knownImaging study manifest provider

          EHDSEndpoint.name

          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Endpoint.managingOrganization
          Definition

          The organization that manages this endpoint (even if technically another organization is hosting this in the cloud, it is the organization associated with the data).

          ShortOrganization that manages this endpoint (might not be the organization that exposes the endpoint)
          Comments

          This property is not typically used when searching for Endpoint resources for usage. The typical usage is via the reference from an applicable Organization/Location/Practitioner resource, which is where the context is provided. Multiple Locations may reference a single endpoint, and don't have to be within the same organization resource, but most likely within the same organizational hierarchy.

          Control0..1
          TypeReference(Organization (EU base), Organization)
          Is Modifierfalse
          Must Supportfalse
          Obligations
            ObligationsActorDocumentation
            SHALL:populate-if-knownImaging study manifest provider

            EHDSEndpoint.managingOrganization

            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. Endpoint.payload
            Definition

            The set of payloads that are provided/available at this endpoint.

            ShortSet of payloads that are provided by this endpoint
            Comments

            Note that not all mimetypes or types will be listed under the one endpoint resource, there may be multiple instances that information for cases where other header data such as the endpoint address, active status/period etc. is different.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Obligations
              ObligationsActorDocumentation
              SHALL:populate-if-knownImaging study manifest provider

              EHDSEndpoint.payload

              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. Endpoint.payload.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              22. Endpoint.payload.type
              Definition

              The payload type describes the acceptable content that can be communicated on the endpoint.

              ShortThe type of content that may be used at this endpoint (e.g. XDS Discharge summaries)
              Comments

              The mimeType describes the serialization format of the data, where the payload.type indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

              Control0..*
              BindingFor example codes, see EndpointPayloadTypehttp://hl7.org/fhir/ValueSet/endpoint-payload-type
              (example to http://hl7.org/fhir/ValueSet/endpoint-payload-type)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Obligations
                ObligationsActorDocumentation
                SHALL:populate-if-knownImaging study manifest provider

                EHDSEndpoint.payload.type

                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. Endpoint.payload.mimeType
                Definition

                The mime type to send the payload in - e.g. application/fhir+xml, application/fhir+json. If the mime type is not specified, then the sender could send any content (including no content depending on the connectionType).

                ShortMimetype to send. If not specified, the content could be anything (including no payload, if the connectionType defined this)
                Comments

                Sending the payload has obvious security consequences. The server is responsible for ensuring that the content is appropriately secured.

                Control0..*
                BindingThe codes SHALL be taken from MimeTypeshttp://hl7.org/fhir/ValueSet/mimetypes|5.0.0
                (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

                BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Obligations
                  ObligationsActorDocumentation
                  SHALL:populate-if-knownImaging study manifest provider

                  EHDSEndpoint.payload.mimeType

                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  26. Endpoint.address
                  Definition

                  The uri that describes the actual end-point to connect to.

                  ShortThe technical base address for connecting to this endpoint
                  Comments

                  For rest-hook, and websocket, the end-point must be an http: or https: URL; for email, a mailto: url, for sms, a tel: url, and for message the endpoint can be in any form of url the server understands (usually, http: or mllp:). The URI is allowed to be relative; in which case, it is relative to the server end-point (since there may be more than one, clients should avoid using relative URIs)

                  This address will be to the service base, without any parameters, or sub-services or resources tacked on.

                  E.g. for a WADO-RS endpoint, the url should be "https://pacs.hospital.org/wado-rs"

                  and not "https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/...".

                  Control1..1
                  Typeurl
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Obligations
                    ObligationsActorDocumentation
                    SHALL:populate-if-knownImaging study manifest provider

                    EHDSEndpoint.address

                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. Endpoint.header
                    Definition

                    Additional headers / information to send as part of the notification.

                    ShortUsage depends on the channel type
                    Comments

                    Exactly what these mean depends on the channel type. The can convey additional information to the recipient and/or meet security requirements.

                    Control0..*
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Obligations
                      ObligationsActorDocumentation
                      SHALL:populate-if-knownImaging study manifest provider

                      EHDSEndpoint.header

                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. Endpoint
                      2. Endpoint.identifier
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Obligations
                        ObligationsActorDocumentation
                        SHALL:populate-if-knownImaging study manifest provider

                        EHDSEndpoint.identifier

                        4. Endpoint.status
                        Obligations
                          ObligationsActorDocumentation
                          SHALL:populate-if-knownImaging study manifest provider

                          EHDSEndpoint.status

                          6. Endpoint.connectionType
                          Obligations
                            ObligationsActorDocumentation
                            SHALL:populate-if-knownImaging study manifest provider

                            EHDSEndpoint.connectionType

                            8. Endpoint.name
                            Obligations
                              ObligationsActorDocumentation
                              SHALL:populate-if-knownImaging study manifest provider

                              EHDSEndpoint.name

                              10. Endpoint.managingOrganization
                              Obligations
                                ObligationsActorDocumentation
                                SHALL:populate-if-knownImaging study manifest provider

                                EHDSEndpoint.managingOrganization

                                12. Endpoint.payload
                                Obligations
                                  ObligationsActorDocumentation
                                  SHALL:populate-if-knownImaging study manifest provider

                                  EHDSEndpoint.payload

                                  14. Endpoint.payload.type
                                  Obligations
                                    ObligationsActorDocumentation
                                    SHALL:populate-if-knownImaging study manifest provider

                                    EHDSEndpoint.payload.type

                                    16. Endpoint.payload.mimeType
                                    Obligations
                                      ObligationsActorDocumentation
                                      SHALL:populate-if-knownImaging study manifest provider

                                      EHDSEndpoint.payload.mimeType

                                      18. Endpoint.address
                                      Obligations
                                        ObligationsActorDocumentation
                                        SHALL:populate-if-knownImaging study manifest provider

                                        EHDSEndpoint.address

                                        20. Endpoint.header
                                        Obligations
                                          ObligationsActorDocumentation
                                          SHALL:populate-if-knownImaging study manifest provider

                                          EHDSEndpoint.header

                                          Guidance on how to interpret the contents of this table can be foundhere

                                          0. Endpoint
                                          Definition

                                          The technical details of an endpoint that can be used for electronic services, such as for web services providing XDS.b, a REST endpoint for another FHIR server, or a s/Mime email address. This may include any security context information.

                                          ShortThe technical details of an endpoint that can be used for electronic services
                                          Control0..*
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                          dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                          2. Endpoint.id
                                          Definition

                                          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                          ShortLogical id of this artifact
                                          Comments

                                          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

                                          Control0..1
                                          Typeid
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summarytrue
                                          4. Endpoint.meta
                                          Definition

                                          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                          ShortMetadata about the resource
                                          Control0..1
                                          TypeMeta
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          6. Endpoint.implicitRules
                                          Definition

                                          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                          ShortA set of rules under which this content was created
                                          Comments

                                          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

                                          Control0..1
                                          Typeuri
                                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          8. Endpoint.language
                                          Definition

                                          The base language in which the resource is written.

                                          ShortLanguage of the resource content
                                          Comments

                                          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                          Control0..1
                                          BindingThe codes SHALL be taken from AllLanguages
                                          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                                          IETF language tag for a human language

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          10. Endpoint.text
                                          Definition

                                          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                          ShortText summary of the resource, for human interpretation
                                          Comments

                                          Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                          Control0..1
                                          This element is affected by the following invariants: dom-6
                                          TypeNarrative
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate Namesnarrative, html, xhtml, display
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          12. Endpoint.contained
                                          Definition

                                          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                                          ShortContained, inline Resources
                                          Comments

                                          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

                                          Control0..*
                                          This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                                          TypeResource
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate Namesinline resources, anonymous resources, contained resources
                                          14. Endpoint.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          16. Endpoint.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                          Must Supportfalse
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          18. Endpoint.identifier
                                          Definition

                                          Identifier for the organization that is used to identify the endpoint across multiple disparate systems.

                                          ShortIdentifies this endpoint across multiple systems
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..*
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Obligations
                                            ObligationsActorDocumentation
                                            SHALL:populate-if-knownImaging study manifest provider

                                            EHDSEndpoint.identifier

                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            20. Endpoint.status
                                            Definition

                                            The endpoint status represents the general expected availability of an endpoint.

                                            Shortactive | suspended | error | off | entered-in-error | test
                                            Comments

                                            This element is labeled as a modifier because the status contains codes that mark the endpoint as not currently valid. Temporary downtimes or other unexpected short-term changes in availability would not be represented in this property.

                                            Control1..1
                                            BindingThe codes SHALL be taken from EndpointStatus
                                            (required to http://hl7.org/fhir/ValueSet/endpoint-status|5.0.0)

                                            The status of the endpoint.

                                            Typecode
                                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Obligations
                                              ObligationsActorDocumentation
                                              SHALL:populate-if-knownImaging study manifest provider

                                              EHDSEndpoint.status

                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              22. Endpoint.connectionType
                                              Definition

                                              A coded value that represents the technical details of the usage of this endpoint, such as what WSDLs should be used in what way. (e.g. XDS.b/DICOM/cds-hook).

                                              ShortProtocol/Profile/Standard to be used with this endpoint connection
                                              Comments

                                              For additional connectivity details for the protocol, extensions will be used at this point, as in the XDS example. If there are multiple payload types or mimetypes they are all applicable for all connection types, and all have the same status.

                                              Control1..*
                                              BindingFor example codes, see EndpointConnectionType
                                              (example to http://hl7.org/fhir/ValueSet/endpoint-connection-type)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Obligations
                                                ObligationsActorDocumentation
                                                SHALL:populate-if-knownImaging study manifest provider

                                                EHDSEndpoint.connectionType

                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                24. Endpoint.name
                                                Definition

                                                A friendly name that this endpoint can be referred to with.

                                                ShortA name that this endpoint can be identified by
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Obligations
                                                  ObligationsActorDocumentation
                                                  SHALL:populate-if-knownImaging study manifest provider

                                                  EHDSEndpoint.name

                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  26. Endpoint.description
                                                  Definition

                                                  The description of the endpoint and what it is for (typically used as supplemental information in an endpoint directory describing its usage/purpose).

                                                  ShortAdditional details about the endpoint that could be displayed as further information to identify the description beyond its name
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  28. Endpoint.environmentType
                                                  Definition

                                                  The type of environment(s) exposed at this endpoint (dev, prod, test, etc.).

                                                  ShortThe type of environment(s) exposed at this endpoint
                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from EndpointEnvironment
                                                  (extensible to http://hl7.org/fhir/ValueSet/endpoint-environment)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  30. Endpoint.managingOrganization
                                                  Definition

                                                  The organization that manages this endpoint (even if technically another organization is hosting this in the cloud, it is the organization associated with the data).

                                                  ShortOrganization that manages this endpoint (might not be the organization that exposes the endpoint)
                                                  Comments

                                                  This property is not typically used when searching for Endpoint resources for usage. The typical usage is via the reference from an applicable Organization/Location/Practitioner resource, which is where the context is provided. Multiple Locations may reference a single endpoint, and don't have to be within the same organization resource, but most likely within the same organizational hierarchy.

                                                  Control0..1
                                                  TypeReference(Organization (EU base))
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Obligations
                                                    ObligationsActorDocumentation
                                                    SHALL:populate-if-knownImaging study manifest provider

                                                    EHDSEndpoint.managingOrganization

                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    32. Endpoint.contact
                                                    Definition

                                                    Contact details for a human to contact about the endpoint. The primary use of this for system administrator troubleshooting.

                                                    ShortContact details for source (e.g. troubleshooting)
                                                    Control0..*
                                                    TypeContactPoint
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    34. Endpoint.period
                                                    Definition

                                                    The interval during which the endpoint is expected to be operational.

                                                    ShortInterval the endpoint is expected to be operational
                                                    Comments

                                                    Temporary downtimes or other short-term changes in availability would not be represented in this property.

                                                    Control0..1
                                                    TypePeriod
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    36. Endpoint.payload
                                                    Definition

                                                    The set of payloads that are provided/available at this endpoint.

                                                    ShortSet of payloads that are provided by this endpoint
                                                    Comments

                                                    Note that not all mimetypes or types will be listed under the one endpoint resource, there may be multiple instances that information for cases where other header data such as the endpoint address, active status/period etc. is different.

                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Obligations
                                                      ObligationsActorDocumentation
                                                      SHALL:populate-if-knownImaging study manifest provider

                                                      EHDSEndpoint.payload

                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      38. Endpoint.payload.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      40. Endpoint.payload.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      42. Endpoint.payload.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      44. Endpoint.payload.type
                                                      Definition

                                                      The payload type describes the acceptable content that can be communicated on the endpoint.

                                                      ShortThe type of content that may be used at this endpoint (e.g. XDS Discharge summaries)
                                                      Comments

                                                      The mimeType describes the serialization format of the data, where the payload.type indicates the specific document/schema that is being transferred; e.g. DischargeSummary or CarePlan.

                                                      Control0..*
                                                      BindingFor example codes, see EndpointPayloadType
                                                      (example to http://hl7.org/fhir/ValueSet/endpoint-payload-type)
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Obligations
                                                        ObligationsActorDocumentation
                                                        SHALL:populate-if-knownImaging study manifest provider

                                                        EHDSEndpoint.payload.type

                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        46. Endpoint.payload.mimeType
                                                        Definition

                                                        The mime type to send the payload in - e.g. application/fhir+xml, application/fhir+json. If the mime type is not specified, then the sender could send any content (including no content depending on the connectionType).

                                                        ShortMimetype to send. If not specified, the content could be anything (including no payload, if the connectionType defined this)
                                                        Comments

                                                        Sending the payload has obvious security consequences. The server is responsible for ensuring that the content is appropriately secured.

                                                        Control0..*
                                                        BindingThe codes SHALL be taken from MimeTypes
                                                        (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

                                                        BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Obligations
                                                          ObligationsActorDocumentation
                                                          SHALL:populate-if-knownImaging study manifest provider

                                                          EHDSEndpoint.payload.mimeType

                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          48. Endpoint.address
                                                          Definition

                                                          The uri that describes the actual end-point to connect to.

                                                          ShortThe technical base address for connecting to this endpoint
                                                          Comments

                                                          For rest-hook, and websocket, the end-point must be an http: or https: URL; for email, a mailto: url, for sms, a tel: url, and for message the endpoint can be in any form of url the server understands (usually, http: or mllp:). The URI is allowed to be relative; in which case, it is relative to the server end-point (since there may be more than one, clients should avoid using relative URIs)

                                                          This address will be to the service base, without any parameters, or sub-services or resources tacked on.

                                                          E.g. for a WADO-RS endpoint, the url should be "https://pacs.hospital.org/wado-rs"

                                                          and not "https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/...".

                                                          Control1..1
                                                          Typeurl
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Obligations
                                                            ObligationsActorDocumentation
                                                            SHALL:populate-if-knownImaging study manifest provider

                                                            EHDSEndpoint.address

                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            50. Endpoint.header
                                                            Definition

                                                            Additional headers / information to send as part of the notification.

                                                            ShortUsage depends on the channel type
                                                            Comments

                                                            Exactly what these mean depends on the channel type. The can convey additional information to the recipient and/or meet security requirements.

                                                            Control0..*
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Obligations
                                                              ObligationsActorDocumentation
                                                              SHALL:populate-if-knownImaging study manifest provider

                                                              EHDSEndpoint.header

                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))