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Resource Profile: Bundle – HDDT CGM Summary Report

This profile defines the exchange of aggregated measurement data for the Mandatory Interoperable Value (MIV) "Continuous Glucose Measurement". By this it provides a patient’s glucose profile for a defined period. The MIV "Continuous Glucose Measurement" is e.g. implemented by real-time Continuous Glocose Monitoring devices (rtCGM) and Automated Insulin Delivery systems (AID) that control an insulin pump from rtCGM data. Future non-invasive measuring methods will expectedly be linked with this MIV and therefore use this profile for sharing aggregated glucose profile data with DiGA, too.

This profile constrains the FHIR Bundle resource for use as the result container of the $hddt-cgm-summary operation.
The operation requests a patient’s glucose profile. The glucose profile is calculated form continuous glucose measurement data and consists of the machine-readable parts of the HL7 CGM summary profile.

The Bundle is of type collection and MUST contain only resources of the following types:

• Observations conforming to HL7 CGM profiles:
  • CGM Summary Observation
  • Mean Glucose (Mass)
  • Mean Glucose (Moles)
  • Times in Ranges
  • Glycemic Variability Index (GMI)
  • Coefficient of Variation
  • Days of Wear!
  • Sensor Active Percentage
• Device resources conforming to HddtPersonalHealthDevice to provide context about the actual Personal Health Device device used.

The purpose of this Bundle profile is to provide a consistent structure for server responses when clients query for CGM data with aggregation logic.
It ensures interoperability across different implementations by defining a predictable response format.
This supports use cases such as:

• Retrieval of CGM summary metrics over a given time interval in support for the upcoming digital disease management program (dDMP) on Diabetes, e.g. for
  • continuous therapy monitoring and adjustment
  • forwarding key data to treating physicians, e.g. for clinical decision support
  • supporting asynchonous telemonitoring by ad hoc provisioning of condensed status information
• Combining aggregated measurement data and device metadata for downstream applications such as visualization or compliance monitoring

Constraints applied:

• Bundle.type is fixed to collection.
• Bundle.entry.resource is restricted to CGM Observation profiles and HddtPersonalHealthDevice. No other resource types are allowed in the Bundle.
• Bundle.entry is set as mandatory. A requests for a CGM summary that would result in an empty bundle, MUST give an OperationOutcome with an error or warning message as its response. Therefore there is no scenario where an empty bundle would be shared with a DiGA.

Usages:

• Examples for this Profile: Bundle/example-cgm-summary-bundle

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	Σ	1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	Σ	0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle		0..*	Bundle	Contains a collection of resources
type		1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Fixed Value: collection
entry		1..*	BackboneElement	Entry in the bundle - will have a resource or information
resource		0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	Σ	0..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	0..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	Σ	0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
signature	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.search.​mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Bundle

Summary

Mandatory: 1 element
Fixed: 1 element

Structures

This structure refers to these other structures:

• CGM Summary Observation (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary)
• Mean Glucose (Mass) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-mean-glucose-mass-per-volume)
• Mean Glucose (Molar) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-mean-glucose-moles-per-volume)
• CGM Times in Ranges (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-times-in-ranges)
• Glucose Management Indicator (GMI) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-gmi)
• Coefficient of Variation (CV) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-coefficient-of-variation)
• Days of Wear (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-days-of-wear)
• Sensor Active Percentage (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-sensor-active-percentage)
• Device – Personal Health Device (https://gematik.de/fhir/hddt/StructureDefinition/hddt-personal-health-device)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
type	Σ	1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	Σ	0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle		0..*	Bundle	Contains a collection of resources
type		1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Fixed Value: collection
entry		1..*	BackboneElement	Entry in the bundle - will have a resource or information
resource		0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Bundle	C	0..*	Bundle	Contains a collection of resources Constraints: bdl-1, bdl-2, bdl-3, bdl-4, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	Σ	0..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	The bundle is always a collection of CGM summary Observations and optionally related Device and DeviceMetric resources returned by the $hddt-cgm-summary operation. Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	0..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
entry	ΣC	1..*	BackboneElement	Entry in the bundle - will have a resource or information Constraints: bdl-5, bdl-8 This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	Σ	0..1		Observations with their related Device and DeviceMetric information
resource			Observation(CGMSummaryObservation | CGMSummaryMeanGlucoseMassPerVolume | CGMSummaryMeanGlucoseMolesPerVolume | CGMSummaryTimesInRanges | CGMSummaryGMI | CGMSummaryCoefficientOfVariation | CGMSummaryDaysOfWear | CGMSummarySensorActivePercentage)
resource			Device(HddtPersonalHealthDevice)
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
signature	Σ	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Bundle.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Bundle.type	Base	required	BundleType	📍4.0.1	FHIR Std.
Bundle.entry.search.​mode	Base	required	SearchEntryMode	📍4.0.1	FHIR Std.
Bundle.entry.request.​method	Base	required	HTTPVerb	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
bdl-1	error	Bundle	total only when a search or history	total.empty() or (type = 'searchset') or (type = 'history')
bdl-2	error	Bundle	entry.search only when a search	entry.search.empty() or (type = 'searchset')
bdl-3	error	Bundle	entry.request mandatory for batch/transaction/history, otherwise prohibited	entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4	error	Bundle	entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited	entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-5	error	Bundle.entry	must be a resource unless there's a request or response	resource.exists() or request.exists() or response.exists()
bdl-7	error	Bundle	FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)	(type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-8	error	Bundle.entry	fullUrl cannot be a version specific reference	fullUrl.contains('/_history/').not()
bdl-9	error	Bundle	A document must have an identifier with a system and a value	type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10	error	Bundle	A document must have a date	type = 'document' implies (timestamp.hasValue())
bdl-11	error	Bundle	A document must have a Composition as the first resource	type = 'document' implies entry.first().resource.is(Composition)
bdl-12	error	Bundle	A message must have a MessageHeader as the first resource	type = 'message' implies entry.first().resource.is(MessageHeader)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Bundle

Summary

Mandatory: 1 element
Fixed: 1 element

Structures

This structure refers to these other structures:

• CGM Summary Observation (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary)
• Mean Glucose (Mass) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-mean-glucose-mass-per-volume)
• Mean Glucose (Molar) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-mean-glucose-moles-per-volume)
• CGM Times in Ranges (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-times-in-ranges)
• Glucose Management Indicator (GMI) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-gmi)
• Coefficient of Variation (CV) (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-coefficient-of-variation)
• Days of Wear (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-days-of-wear)
• Sensor Active Percentage (http://hl7.org/fhir/uv/cgm/StructureDefinition/cgm-summary-sensor-active-percentage)
• Device – Personal Health Device (https://gematik.de/fhir/hddt/StructureDefinition/hddt-personal-health-device)

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