Athena Core Implementation Guide
4.2.0 - release

Athena Core Implementation Guide - Local Development build (v4.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AthenahealthBinary - Detailed Descriptions

Active as of 2025-04-17

Definitions for the ah-binary resource profile.

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

0. Binary
2. Binary.meta
4. Binary.meta.lastUpdated
Comments

This value might be populated. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

6. Binary.meta.security
Comments

meta.security will contain an item with code 'NOPAT' if the resource is a lab or imaging result and is indicated confidential due to the risk of patient harm.

8. Binary.securityContext
Control0..0

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

0. Binary
Definition

A resource that represents the data of a single raw artifact as digital content accessible in its native format. A Binary resource can contain any content, whether text, image, pdf, zip archive, etc.

ShortPure binary content defined by a format other than FHIR
Comments

Typically, Binary resources are used for handling content such as:

  • CDA Documents (i.e. with XDS)
  • PDF Documents
  • Images (the Media resource is preferred for handling images, but not possible when the content is already binary - e.g. XDS).
Control0..*
Is Modifierfalse
Summaryfalse
2. Binary.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. Binary.contentType
Definition

MimeType of the binary content represented as a standard MimeType (BCP 13).

ShortMimeType of the binary content
Control1..1
BindingThe codes SHALL be taken from Mime Typeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
(required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

The mime type of an attachment. Any valid mime type is allowed.

Typecode
Is Modifierfalse
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()))
6. Binary.securityContext
Definition

This element identifies another resource that can be used as a proxy of the security sensitivity to use when deciding and enforcing access control rules for the Binary resource. Given that the Binary resource contains very few elements that can be used to determine the sensitivity of the data and relationships to individuals, the referenced resource stands in as a proxy equivalent for this purpose. This referenced resource may be related to the Binary (e.g. Media, DocumentReference), or may be some non-related Resource purely as a security proxy. E.g. to identify that the binary resource relates to a patient, and access should only be granted to applications that have access to the patient.

ShortIdentifies another resource to use as proxy when enforcing access control
Comments

Very often, a server will also know of a resource that references the binary, and can automatically apply the appropriate access rules based on that reference. However, there are some circumstances where this is not appropriate, e.g. the binary is uploaded directly to the server without any linking resource, the binary is referred to from multiple different resources, and/or the binary is content such as an application logo that has less protection than any of the resources that reference it.

Control0..01
TypeReference(Resource)
Is Modifierfalse
Summarytrue
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 found here

0. Binary
Definition

A resource that represents the data of a single raw artifact as digital content accessible in its native format. A Binary resource can contain any content, whether text, image, pdf, zip archive, etc.

ShortPure binary content defined by a format other than FHIR
Comments

Typically, Binary resources are used for handling content such as:

  • CDA Documents (i.e. with XDS)
  • PDF Documents
  • Images (the Media resource is preferred for handling images, but not possible when the content is already binary - e.g. XDS).
Control0..*
Is Modifierfalse
Summaryfalse
2. Binary.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. Binary.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. Binary.meta.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
8. Binary.meta.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())
SlicingThis element introduces a set of slices on Binary.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Binary.meta.versionId
    Definition

    The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

    ShortVersion specific identifier
    Comments

    The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

    Control0..1
    Typeid
    Is Modifierfalse
    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()))
    12. Binary.meta.lastUpdated
    Definition

    When the resource last changed - e.g. when the version changed.

    ShortWhen the resource version last changed
    Comments

    This value might be populated. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

    Control0..1
    Typeinstant
    Is Modifierfalse
    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()))
    14. Binary.meta.source
    Definition

    A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

    ShortIdentifies where the resource comes from
    Comments

    In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

    This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

    Control0..1
    Typeuri
    Is Modifierfalse
    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()))
    16. Binary.meta.profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control0..*
    Typecanonical(StructureDefinition)
    Is Modifierfalse
    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()))
    18. Binary.meta.security
    Definition

    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

    ShortSecurity Labels applied to this resource
    Comments

    meta.security will contain an item with code 'NOPAT' if the resource is a lab or imaging result and is indicated confidential due to the risk of patient harm.

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

    Security Labels from the Healthcare Privacy and Security Classification System.

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Binary.meta.tag
    Definition

    Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

    ShortTags applied to this resource
    Comments

    The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control0..*
    BindingFor example codes, see CommonTags
    (example to http://hl7.org/fhir/ValueSet/common-tags)

    Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Binary.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()))
    24. Binary.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)

    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()))
    26. Binary.contentType
    Definition

    MimeType of the binary content represented as a standard MimeType (BCP 13).

    ShortMimeType of the binary content
    Control1..1
    BindingThe codes SHALL be taken from Mime Types
    (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

    The mime type of an attachment. Any valid mime type is allowed.

    Typecode
    Is Modifierfalse
    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()))
    28. Binary.securityContext
    Definition

    This element identifies another resource that can be used as a proxy of the security sensitivity to use when deciding and enforcing access control rules for the Binary resource. Given that the Binary resource contains very few elements that can be used to determine the sensitivity of the data and relationships to individuals, the referenced resource stands in as a proxy equivalent for this purpose. This referenced resource may be related to the Binary (e.g. Media, DocumentReference), or may be some non-related Resource purely as a security proxy. E.g. to identify that the binary resource relates to a patient, and access should only be granted to applications that have access to the patient.

    ShortIdentifies another resource to use as proxy when enforcing access control
    Comments

    Very often, a server will also know of a resource that references the binary, and can automatically apply the appropriate access rules based on that reference. However, there are some circumstances where this is not appropriate, e.g. the binary is uploaded directly to the server without any linking resource, the binary is referred to from multiple different resources, and/or the binary is content such as an application logo that has less protection than any of the resources that reference it.

    Control0..0
    TypeReference(Resource)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Binary.data
    Definition

    The actual content, base64 encoded.

    ShortThe actual content
    Comments

    If the content type is itself base64 encoding, then this will be base64 encoded twice - what is created by un-base64ing the content must be the specified content type.

    Control0..1
    Typebase64Binary
    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()))