Attachment Reference Exchange (ARex)
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Attachment Reference Exchange (ARex) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ARex Manifest ( Experimental )

Official URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-manifest Version: 0.1.0
Draft as of 2026-08-12 Computable Name: ARexManifest

A signed, expiring index of content objects made available out-of-band from the transaction they support. The manifest is the unit of authorization, the unit of expiry, and the unit of revocation.

Usages:

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.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: lst-1, lst-2, lst-3, arex-man-1, arex-man-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
Binding: ListStatus (required): The current state of the list.
... mode ?!Σ 1..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this list.
Fixed Value: snapshot
... title SΣ 0..1 string Descriptive name for the list
Example General: Dr. Jane's Patients
... code SΣ 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject SΣ 1..1 Reference(Patient) If all resources have the same subject
... date SΣ 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source SΣ 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... note S 0..* Annotation Comments about the list
... entry SC 0..* BackboneElement Entries in the list
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item S 1..1 Reference(ARex Content Entry) Actual entry

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
List.status Base required ListStatus 📍4.0.1 FHIR Std.
List.mode Base required ListMode 📍4.0.1 FHIR Std.
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()

This structure is derived from List

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: arex-man-1, arex-man-2
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... identifier S 1..1 Identifier Stable manifest identifier; preserved across retraction
... status S 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
... title S 0..1 string Descriptive name for the list
... code S 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject S 1..1 Reference(Patient) If all resources have the same subject
... date S 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source S 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... note S 0..* Annotation Comments about the list
... entry S 0..* BackboneElement Entries in the list
.... deleted 0..0 If this item is actually marked as deleted
.... item S 1..1 Reference(ARex Content Entry) Actual entry

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: lst-1, lst-2, lst-3, arex-man-1, arex-man-2
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..1 Identifier Stable manifest identifier; preserved across retraction
... status ?!SΣ 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
Binding: ListStatus (required): The current state of the list.
... mode ?!Σ 1..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this list.
Fixed Value: snapshot
... title SΣ 0..1 string Descriptive name for the list
Example General: Dr. Jane's Patients
... code SΣ 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject SΣ 1..1 Reference(Patient) If all resources have the same subject
... encounter 0..1 Reference(Encounter) Context in which list created
... date SΣ 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source SΣ 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... orderedBy 0..1 CodeableConcept What order the list has
Binding: ListOrderCodes (preferred): What order applies to the items in a list.
... note S 0..* Annotation Comments about the list
... entry SC 0..* BackboneElement Entries in the list
.... 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
.... flag 0..1 CodeableConcept Status/Workflow information about this item
Binding: PatientMedicineChangeTypes (example): Codes that provide further information about the reason and meaning of the item in the list.
.... date 0..1 dateTime When item added to list
.... item S 1..1 Reference(ARex Content Entry) Actual entry
... emptyReason C 0..1 CodeableConcept Why list is empty
Binding: ListEmptyReasons (preferred): If a list is empty, why it is empty.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
List.language Base preferred Common Languages 📍4.0.1 FHIR Std.
List.status Base required ListStatus 📍4.0.1 FHIR Std.
List.mode Base required ListMode 📍4.0.1 FHIR Std.
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG
List.orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
List.entry.flag Base example Patient Medicine Change Types 📍4.0.1 FHIR Std.
List.emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()

This structure is derived from List

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: lst-1, lst-2, lst-3, arex-man-1, arex-man-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
Binding: ListStatus (required): The current state of the list.
... mode ?!Σ 1..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this list.
Fixed Value: snapshot
... title SΣ 0..1 string Descriptive name for the list
Example General: Dr. Jane's Patients
... code SΣ 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject SΣ 1..1 Reference(Patient) If all resources have the same subject
... date SΣ 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source SΣ 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... note S 0..* Annotation Comments about the list
... entry SC 0..* BackboneElement Entries in the list
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item S 1..1 Reference(ARex Content Entry) Actual entry

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
List.status Base required ListStatus 📍4.0.1 FHIR Std.
List.mode Base required ListMode 📍4.0.1 FHIR Std.
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()

Differential View

This structure is derived from List

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: arex-man-1, arex-man-2
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... identifier S 1..1 Identifier Stable manifest identifier; preserved across retraction
... status S 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
... title S 0..1 string Descriptive name for the list
... code S 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject S 1..1 Reference(Patient) If all resources have the same subject
... date S 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source S 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... note S 0..* Annotation Comments about the list
... entry S 0..* BackboneElement Entries in the list
.... deleted 0..0 If this item is actually marked as deleted
.... item S 1..1 Reference(ARex Content Entry) Actual entry

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. List C 0..* List A list is a curated collection of resources
Constraints: lst-1, lst-2, lst-3, arex-man-1, arex-man-2
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:expires S 1..1 instant ARex Expires
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires
.... extension:requiresAccessToken S 1..1 boolean ARex Requires Access Token
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-requires-access-token
.... extension:transactionContext S 1..1 (Complex) ARex Transaction Context
URL: https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-transaction-context
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..1 Identifier Stable manifest identifier; preserved across retraction
... status ?!SΣ 1..1 code current | retracted | entered-in-error. Revocation is expressed as 'retracted'.
Binding: ListStatus (required): The current state of the list.
... mode ?!Σ 1..1 code working | snapshot | changes
Binding: ListMode (required): The processing mode that applies to this list.
Fixed Value: snapshot
... title SΣ 0..1 string Descriptive name for the list
Example General: Dr. Jane's Patients
... code SΣ 1..1 CodeableConcept What the purpose of this list is
Binding: ARex Manifest Type Value Set (required)
... subject SΣ 1..1 Reference(Patient) If all resources have the same subject
... encounter 0..1 Reference(Encounter) Context in which list created
... date SΣ 1..1 dateTime Publication instant of this manifest, analogous to Bulk Data transactionTime
... source SΣ 0..1 Reference(PractitionerRole | Device) Who and/or what defined the list contents (aka Author)
... orderedBy 0..1 CodeableConcept What order the list has
Binding: ListOrderCodes (preferred): What order applies to the items in a list.
... note S 0..* Annotation Comments about the list
... entry SC 0..* BackboneElement Entries in the list
.... 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
.... flag 0..1 CodeableConcept Status/Workflow information about this item
Binding: PatientMedicineChangeTypes (example): Codes that provide further information about the reason and meaning of the item in the list.
.... date 0..1 dateTime When item added to list
.... item S 1..1 Reference(ARex Content Entry) Actual entry
... emptyReason C 0..1 CodeableConcept Why list is empty
Binding: ListEmptyReasons (preferred): If a list is empty, why it is empty.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
List.language Base preferred Common Languages 📍4.0.1 FHIR Std.
List.status Base required ListStatus 📍4.0.1 FHIR Std.
List.mode Base required ListMode 📍4.0.1 FHIR Std.
List.code Base required ARex Manifest Type Value Set 📦0.1.0 This IG
List.orderedBy Base preferred List Order Codes 📍4.0.1 FHIR Std.
List.entry.flag Base example Patient Medicine Change Types 📍4.0.1 FHIR Std.
List.emptyReason Base preferred List Empty Reasons 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
arex-man-1 error List The expiry instant SHALL be later than the manifest publication date. extension('https://fhir.onyxhealth.io/us/arex/StructureDefinition/arex-expires').value.as(instant) > date
arex-man-2 error List A manifest SHALL contain at least one entry unless it has been retracted. status = 'retracted' or entry.exists()

This structure is derived from List

 

Other representations of profile: CSV, Excel, Schematron