Integrated Campaign Registry (ICR) Implementation Guide
0.1.0 - ci-build International flag

Integrated Campaign Registry (ICR) Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ICRDeliveryUnit - Detailed Descriptions

Draft as of 2026-10-29

Definitions for the ICRDeliveryUnit resource profile.

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

0. Group
Definition

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.

ShortGroup of multiple entities
Comments

If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.

Control0..*
Is Modifierfalse
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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())
grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
icr-du-one-head: At most one active member is coded head (the reference head); other heads are coded co-head. (member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).count() <= 1)
icr-du-head: A household with at least one active member should have an active member coded head. ((code.coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-group-kind-cs' and code = 'household').exists() and member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now())).exists()) implies member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).exists())
grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
2. Group.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 it's 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 it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Group.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control10..*
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())
SlicingThis element introduces a set of slices on Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Group.extension:groupLocation
    Slice NamegroupLocation
    Definition

    The physical Location of a delivery-unit Group — the validated Ona pattern: Group (who) + Location (where). For a household the Location is the dwelling (carrying the GERS building ID); for a community it is the settlement or community point; for a school cohort it is the school. This is the group's RESIDENCE/BASE, not its service point: where service actually happened is Task.location and the delivery event's own location — a household served at a village distribution center keeps its dwelling here unchanged (working doc 7.5, 7.5,

    ShortResidence/base, not service point: the dwelling (household), settlement/community point (community), or school (school-cohort)
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Group Location) (Extension Type: Reference(ICR Location))
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Group.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 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).

    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
    Summaryfalse
    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())
    10. Group.type
    Definition

    Identifies the broad classification of the kind of resources the group includes.

    Shortperson | animal | practitioner | device | medication | substance
    Comments

    Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).

    Control1..1
    BindingThe codes SHALL be taken from GroupTypehttp://hl7.org/fhir/ValueSet/group-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/group-type|4.0.1)

    Types of resources that are part of group.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Identifies what type of resources the group is made up of.

    Pattern Valueperson
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Group.actual
    Definition

    If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.

    ShortDescriptive or actual
    Control1..1
    This element is affected by the following invariants: grp-1
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.

    Pattern Valuetrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Group.code
    Definition

    Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.

    Shorthousehold | community | school-cohortKind of Group members
    Comments

    This would generally be omitted for Person resources.

    Control10..1
    BindingThe codes SHALL be taken from For example codes, see ICR Group Kind
    (required to https://icr.healthcampaigns.org/ValueSet/icr-group-kind)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Group.quantity
    Definition

    A count of the number of resource instances that are part of the group.

    ShortHead-count fallback where individuals are not enumerated (register-level MDA); coexists with an enumerated member listNumber of members
    Comments

    Note that the quantity may be less than the number of members if some of the members are not active.

    Control0..1
    TypeunsignedInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Group size is a common defining characteristic.

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

    Identifies the resource instances that are members of the group.

    ShortWho or what is in group
    Control0..*
    This element is affected by the following invariants: grp-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Often the only thing of interest about a group is "who's in it".

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Group.member.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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())
    SlicingThis element introduces a set of slices on Group.member.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 22. Group.member.extension:relationshipToHead
      Slice NamerelationshipToHead
      Definition

      How a household member relates to the household's reference head — the question census and DHS household rosters ask. The reference head is coded head; every other code is relative to that person; other heads are coded co-head. When the reference head changes, re-code the other members from the source if it gives relationships to the new head, otherwise remove the codes rather than keep codes that refer to someone else (the earlier codes stay in the Group's version history).

      ShortHow this member relates to the household's reference head: head for the reference head, co-head for other heads, otherwise a relationship to the reference head (v3 RoleCode, with descendants). The head is identified by this code, not by list order
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Relationship to Head of Household) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. Group.member.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 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).

      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())
      26. Group.member.entity
      Definition

      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.

      ShortThe enumerated individuals — the mainline capture mode for community-and-household campaigns; never a sub-GroupReference to the group member
      Control1..1
      TypeReference(ICR Patient (Beneficiary / Registered Individual), Patient, Practitioner, PractitionerRole, Device, Medication, Substance, Group)
      Is Modifierfalse
      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. Group
      Invariantsicr-du-one-head: At most one active member is coded head (the reference head); other heads are coded co-head. (member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).count() <= 1)
      icr-du-head: A household with at least one active member should have an active member coded head. ((code.coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-group-kind-cs' and code = 'household').exists() and member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now())).exists()) implies member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).exists())
      2. Group.extension
      Control1..?
      SlicingThis element introduces a set of slices on Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. Group.extension:groupLocation
        Slice NamegroupLocation
        ShortResidence/base, not service point: the dwelling (household), settlement/community point (community), or school (school-cohort)
        Control1..1
        TypeExtension(Group Location) (Extension Type: Reference(ICR Location))
        Must Supporttrue
        6. Group.type
        Pattern Valueperson
        8. Group.actual
        Pattern Valuetrue
        10. Group.code
        Shorthousehold | community | school-cohort
        Control1..?
        BindingThe codes SHALL be taken from ICR Group Kind
        (required to https://icr.healthcampaigns.org/ValueSet/icr-group-kind)
        Must Supporttrue
        12. Group.quantity
        ShortHead-count fallback where individuals are not enumerated (register-level MDA); coexists with an enumerated member list
        Must Supporttrue
        14. Group.member
        Must Supporttrue
        16. Group.member.extension
        SlicingThis element introduces a set of slices on Group.member.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 18. Group.member.extension:relationshipToHead
          Slice NamerelationshipToHead
          ShortHow this member relates to the household's reference head: head for the reference head, co-head for other heads, otherwise a relationship to the reference head (v3 RoleCode, with descendants). The head is identified by this code, not by list order
          Control0..1
          TypeExtension(Relationship to Head of Household) (Extension Type: CodeableConcept)
          Must Supporttrue
          20. Group.member.entity
          ShortThe enumerated individuals — the mainline capture mode for community-and-household campaigns; never a sub-Group
          TypeReference(ICR Patient (Beneficiary / Registered Individual))

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

          0. Group
          Definition

          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.

          ShortGroup of multiple entities
          Comments

          If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.

          Control0..*
          Is Modifierfalse
          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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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())
          grp-1: Can only have members if group is "actual" (member.empty() or (actual = true))
          icr-du-one-head: At most one active member is coded head (the reference head); other heads are coded co-head. (member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).count() <= 1)
          icr-du-head: A household with at least one active member should have an active member coded head. ((code.coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-group-kind-cs' and code = 'household').exists() and member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now())).exists()) implies member.where((inactive.empty() or inactive = false) and (period.end.empty() or period.end > now()) and extension('https://icr.healthcampaigns.org/StructureDefinition/relationship-to-head').value.ofType(CodeableConcept).coding.where(system = 'https://icr.healthcampaigns.org/CodeSystem/icr-household-relationship-cs' and code = 'head').exists()).exists())
          2. Group.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

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. Group.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
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Group.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 it's 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 it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Group.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 SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Group.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 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
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Group.contained
          Definition

          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.

          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..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Group.extension
          Definition

          An Extension

          ShortExtension
          Control1..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          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())
          SlicingThis element introduces a set of slices on Group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Group.extension:groupLocation
            Slice NamegroupLocation
            Definition

            The physical Location of a delivery-unit Group — the validated Ona pattern: Group (who) + Location (where). For a household the Location is the dwelling (carrying the GERS building ID); for a community it is the settlement or community point; for a school cohort it is the school. This is the group's RESIDENCE/BASE, not its service point: where service actually happened is Task.location and the delivery event's own location — a household served at a village distribution center keeps its dwelling here unchanged (working doc 7.5, 7.5,

            ShortResidence/base, not service point: the dwelling (household), settlement/community point (community), or school (school-cohort)
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Group Location) (Extension Type: Reference(ICR Location))
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            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. Group.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 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).

            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
            Summaryfalse
            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())
            20. Group.identifier
            Definition

            A unique business identifier for this group.

            ShortUnique id
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows the group to be referenced from external specifications.

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

            Indicates whether the record for the group is available for use or is merely being retained for historical purposes.

            ShortWhether this group's record is in active use
            Control0..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).

            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. Group.type
            Definition

            Identifies the broad classification of the kind of resources the group includes.

            Shortperson | animal | practitioner | device | medication | substance
            Comments

            Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).

            Control1..1
            BindingThe codes SHALL be taken from GroupType
            (required to http://hl7.org/fhir/ValueSet/group-type|4.0.1)

            Types of resources that are part of group.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Identifies what type of resources the group is made up of.

            Pattern Valueperson
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Group.actual
            Definition

            If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.

            ShortDescriptive or actual
            Control1..1
            This element is affected by the following invariants: grp-1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.

            Pattern Valuetrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Group.code
            Definition

            Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.

            Shorthousehold | community | school-cohort
            Comments

            This would generally be omitted for Person resources.

            Control1..1
            BindingThe codes SHALL be taken from ICR Group Kind
            (required to https://icr.healthcampaigns.org/ValueSet/icr-group-kind)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Group.name
            Definition

            A label assigned to the group for human identification and communication.

            ShortLabel for Group
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Used to identify the group in human communication.

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

            A count of the number of resource instances that are part of the group.

            ShortHead-count fallback where individuals are not enumerated (register-level MDA); coexists with an enumerated member list
            Comments

            Note that the quantity may be less than the number of members if some of the members are not active.

            Control0..1
            TypeunsignedInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Group size is a common defining characteristic.

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

            Entity responsible for defining and maintaining Group characteristics and/or registered members.

            ShortEntity that is the custodian of the Group's definition
            Comments

            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.

            Control0..1
            TypeReference(Organization, RelatedPerson, Practitioner, PractitionerRole)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Group.characteristic
            Definition

            Identifies traits whose presence r absence is shared by members of the group.

            ShortInclude / Exclude group members by Trait
            Comments

            All the identified characteristics must be true for an entity to a member of the group.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            Needs to be a generic mechanism for identifying what individuals can be part of a group.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Group.characteristic.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
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            40. Group.characteristic.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 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.

            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. Group.characteristic.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 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).

            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. Group.characteristic.code
            Definition

            A code that identifies the kind of trait being asserted.

            ShortKind of characteristic
            Control1..1
            Binding

            List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Need a formal way of identifying the characteristic being described.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. Group.characteristic.value[x]
            Definition

            The value of the trait that holds (or does not hold - see 'exclude') for members of the group.

            ShortValue held by characteristic
            Comments

            For Range, it means members of the group have a value that falls somewhere within the specified range.

            Control1..1
            Binding

            Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

            TypeChoice of: CodeableConcept, boolean, Quantity, Range, Reference
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            The value of the characteristic is what determines group membership.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Group.characteristic.exclude
            Definition

            If true, indicates the characteristic is one that is NOT held by members of the group.

            ShortGroup includes or excludes
            Comments

            This is labeled as "Is Modifier" because applications cannot wrongly include excluded members as included or vice versa.

            Control1..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Sometimes group membership is determined by characteristics not possessed.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Group.characteristic.period
            Definition

            The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.

            ShortPeriod over which characteristic is tested
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Group.member
            Definition

            Identifies the resource instances that are members of the group.

            ShortWho or what is in group
            Control0..*
            This element is affected by the following invariants: grp-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Often the only thing of interest about a group is "who's in it".

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Group.member.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
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            56. Group.member.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            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())
            SlicingThis element introduces a set of slices on Group.member.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 58. Group.member.extension:relationshipToHead
              Slice NamerelationshipToHead
              Definition

              How a household member relates to the household's reference head — the question census and DHS household rosters ask. The reference head is coded head; every other code is relative to that person; other heads are coded co-head. When the reference head changes, re-code the other members from the source if it gives relationships to the new head, otherwise remove the codes rather than keep codes that refer to someone else (the earlier codes stay in the Group's version history).

              ShortHow this member relates to the household's reference head: head for the reference head, co-head for other heads, otherwise a relationship to the reference head (v3 RoleCode, with descendants). The head is identified by this code, not by list order
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Relationship to Head of Household) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              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())
              60. Group.member.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 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).

              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())
              62. Group.member.entity
              Definition

              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.

              ShortThe enumerated individuals — the mainline capture mode for community-and-household campaigns; never a sub-Group
              Control1..1
              TypeReference(ICR Patient (Beneficiary / Registered Individual))
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. Group.member.period
              Definition

              The period that the member was in the group, if known.

              ShortPeriod member belonged to the group
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to track who was in a group at a particular time.

              Meaning if MissingThe member is in the group at this time
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Group.member.inactive
              Definition

              A flag to indicate that the member is no longer in the group, but previously may have been a member.

              ShortIf member is no longer in group
              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Sometimes you don't know when someone stopped being in a group, but not when.

              Meaning if MissingMembers are considered active unless explicitly specified otherwise
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))