Group

Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	Unique id Details A unique business identifier for this group.
active		boolean	Whether this group's record is in active use Details Indicates whether the record for the group is available for use or is merely being retained for historical purposes.
type	✓	code	person | animal | practitioner | device | medication | substance Details Identifies the broad classification of the kind of resources the group includes. Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).
actual	✓	boolean	Descriptive or actual Details If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.
code		CodeableConcept	Kind of Group members Details Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc. This would generally be omitted for Person resources.
name		string	Label for Group Details A label assigned to the group for human identification and communication.
quantity		unsignedInt	Number of members Details A count of the number of resource instances that are part of the group. Note that the quantity may be less than the number of members if some of the members are not active.
managingEntity		Reference< Organization | RelatedPerson | Practitioner | PractitionerRole >	Entity that is the custodian of the Group's definition Details Entity responsible for defining and maintaining Group characteristics and/or registered members. This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.
characteristic		GroupCharacteristic[]	Include / Exclude group members by Trait Details Identifies traits whose presence r absence is shared by members of the group. All the identified characteristics must be true for an entity to a member of the group.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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 manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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 manageable, 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). 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.
code	✓	CodeableConcept	Kind of characteristic Details A code that identifies the kind of trait being asserted.
value[x]	✓	CodeableConcept, boolean, Quantity, Range, Reference<>	Value held by characteristic Details The value of the trait that holds (or does not hold - see 'exclude') for members of the group. For Range, it means members of the group have a value that falls somewhere within the specified range.
exclude	✓	boolean	Group includes or excludes Details If true, indicates the characteristic is one that is NOT held by members of the group. This is labeled as "Is Modifier" because applications cannot wrongly include excluded members as included or vice versa.
period		Period	Period over which characteristic is tested Details The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.
member		GroupMember[]	Who or what is in group Details Identifies the resource instances that are members of the group.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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 manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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 manageable, 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). 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.
entity	✓	Reference< Patient | Practitioner | PractitionerRole | Device | Medication | Substance | Group >	Reference to the group member Details A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.
period		Period	Period member belonged to the group Details The period that the member was in the group, if known.
inactive		boolean	If member is no longer in group Details A flag to indicate that the member is no longer in the group, but previously may have been a member.

Search Parameters

Name	Type	Description	Expression
actual	token	Descriptive or actual	Group.actual
characteristic	token	Kind of characteristic	Group.characteristic.code
code	token	The kind of resources contained	Group.code
exclude	token	Group includes or excludes	Group.characteristic.exclude
identifier	token	Unique id	Group.identifier
managing-entity	reference	Entity that is the custodian of the Group's definition	Group.managingEntity
member	reference	Reference to the group member	Group.member.entity
type	token	The type of resources the group contains	Group.type
value	token	Value held by characteristic	Group.characteristic.value as CodeableConcept | Group.characteristic.value as boolean
characteristic-value	composite	A composite of both characteristic and value	Group.characteristic

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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 it's narrative along with other profiles, value sets, etc.
language		code	Language of the resource content Details The base language in which the resource is written. 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).
text		Narrative	Text summary of the resource, for human interpretation Details 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. Contained resources do not have 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.
contained		Resource[]	Contained, inline Resources Details These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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.
extension		Extension[]	Additional content defined by implementations Details 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 manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored Details 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 manageable, 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). 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.

Usage

Use Cases

The Group resource is used in one of two ways:

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

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

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

Relationships

There are a number of mechanisms in FHIR for communicating collections of resources:

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

Contained, bundled and remotely referenced resources convey the same meaning.

Referenced By

• DataRequirement
• UsageContext
• ActivityDefinition
• AdverseEvent
• CarePlan
• CareTeam
• ChargeItem
• ClinicalImpression
• Communication
• CommunicationRequest
• Condition
• Consent
• Contract
• DeviceRequest
• DeviceUseStatement
• DiagnosticReport
• DocumentManifest
• DocumentReference
• Encounter
• EventDefinition
• EvidenceVariable
• Flag
• Goal
• GuidanceResponse
• ImagingStudy
• Invoice
• Library
• List
• Measure
• MeasureReport
• Media
• MedicationAdministration
• MedicationDispense
• MedicationRequest
• MedicationStatement
• Observation
• PlanDefinition
• Procedure
• RequestGroup
• ResearchDefinition
• ResearchElementDefinition
• ResearchStudy
• RiskAssessment
• ServiceRequest
• Specimen
• Task