Vital Records FHIR Messaging (VRFM) IG
2.0.0 - release

Vital Records FHIR Messaging (VRFM) IG - Local Development build (v2.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Submission Message Header

Official URL: http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/StructureDefinition/VRM-SubmissionHeader | Version: 2.0.0
Active as of 2025-08-11 | Computable Name: SubmissionHeader

Message Submission Header

Usages:

- Use this Profile: Birth Report Message, Death Record Submission Message and Fetal Death Report Message
- Examples for this Profile: MessageHeader/BirthReportHeader-Example1, MessageHeader/DeathRecordSubmissionHeaderExample1, MessageHeader/FetalDeathReportHeader-Example1 and MessageHeader/SubmissionHeader-Example1

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
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 1..1 | id | Logical id of this artifact
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventUri | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination | Σ | 1..* | BackboneElement | Message destination application(s)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual destination address or id
source | Σ | 1..1 | BackboneElement | Message source application
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual message source address or id
focus | Σ | 1..2 | Reference(Resource) | The actual content of the message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events` From the FHIR Standard
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MessageHeader | 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 | error | MessageHeader | 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 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() |
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 MessageHeader

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  |  | MessageHeader |
id |  | 1..1 | id | Logical id of this artifact
Slices for event[x] |  | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this
event[x]:eventUri |  | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination |  | 1..* | BackboneElement | Message destination application(s)
focus |  | 1..2 | Reference(Resource) | The actual content of the message
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 1..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
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventUri | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination | Σ | 1..* | BackboneElement | Message destination application(s)
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
name | Σ | 0..1 | string | Name of system
target | Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination
endpoint | Σ | 1..1 | url | Actual destination address or id
receiver | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data
sender | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message
enterer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry
author | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision
source | Σ | 1..1 | BackboneElement | Message source application
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
name | Σ | 0..1 | string | Name of system
software | Σ | 0..1 | string | Name of software running the system
version | Σ | 0..1 | string | Version of software running
contact | Σ | 0..1 | ContactPoint | Human contact for problems
endpoint | Σ | 1..1 | url | Actual message source address or id
responsible | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event
reason | Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence.
response | Σ | 0..1 | BackboneElement | If this is a reply to prior message
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
identifier | Σ | 1..1 | id | Id of original message
code | Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message.
details | Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors
focus | Σ | 1..2 | Reference(Resource) | The actual content of the message
definition | Σ | 0..1 | canonical(MessageDefinition) | Link to the definition for this message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events` From the FHIR Standard
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG
MessageHeader.reason | example | ExampleMessageReasonCodes `http://hl7.org/fhir/ValueSet/message-reason-encounter` From the FHIR Standard
MessageHeader.response.code | required | ResponseType `http://hl7.org/fhir/ValueSet/response-code|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MessageHeader | 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 | error | MessageHeader | 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 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() |
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 MessageHeader

Summary

Mandatory: 4 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 1..1 | id | Logical id of this artifact
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventUri | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination | Σ | 1..* | BackboneElement | Message destination application(s)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual destination address or id
source | Σ | 1..1 | BackboneElement | Message source application
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual message source address or id
focus | Σ | 1..2 | Reference(Resource) | The actual content of the message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events` From the FHIR Standard
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MessageHeader | 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 | error | MessageHeader | 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 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() |
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 MessageHeader

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  |  | MessageHeader |
id |  | 1..1 | id | Logical id of this artifact
Slices for event[x] |  | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this
event[x]:eventUri |  | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination |  | 1..* | BackboneElement | Message destination application(s)
focus |  | 1..2 | Reference(Resource) | The actual content of the message
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 1..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
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventUri | Σ | 1..1 | uri | Code for the event this message represents or link to event definition Binding: Submission MessageHeader URI Values (required)
destination | Σ | 1..* | BackboneElement | Message destination application(s)
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
name | Σ | 0..1 | string | Name of system
target | Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination
endpoint | Σ | 1..1 | url | Actual destination address or id
receiver | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data
sender | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message
enterer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry
author | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision
source | Σ | 1..1 | BackboneElement | Message source application
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
name | Σ | 0..1 | string | Name of system
software | Σ | 0..1 | string | Name of software running the system
version | Σ | 0..1 | string | Version of software running
contact | Σ | 0..1 | ContactPoint | Human contact for problems
endpoint | Σ | 1..1 | url | Actual message source address or id
responsible | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event
reason | Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence.
response | Σ | 0..1 | BackboneElement | If this is a reply to prior message
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
identifier | Σ | 1..1 | id | Id of original message
code | Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message.
details | Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors
focus | Σ | 1..2 | Reference(Resource) | The actual content of the message
definition | Σ | 0..1 | canonical(MessageDefinition) | Link to the definition for this message
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MessageHeader.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MessageHeader.event[x] | example | MessageEvent `http://hl7.org/fhir/ValueSet/message-events` From the FHIR Standard
MessageHeader.event[x]:eventUri | required | SubmissionURIVS `http://cdc.gov/nchs/nvss/fhir/vital-records-messaging/ValueSet/VRM-SubmissionHeaderURI-vs` From this IG
MessageHeader.reason | example | ExampleMessageReasonCodes `http://hl7.org/fhir/ValueSet/message-reason-encounter` From the FHIR Standard
MessageHeader.response.code | required | ResponseType `http://hl7.org/fhir/ValueSet/response-code|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MessageHeader | 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 | error | MessageHeader | 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 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management : text.`div`.exists() |
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 MessageHeader

Summary

Mandatory: 4 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]

Other representations of profile: CSV, Excel, Schematron