{
  "resourceType": "StructureDefinition",
  "id": "patient-ca-core",
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 2
    }
  ],
  "url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
  "version": "1.1.0",
  "name": "PatientCACore",
  "title": "Patient (CA-Core)",
  "status": "active",
  "experimental": false,
  "date": "2025-08-27",
  "publisher": "Canada Health Infoway",
  "contact": [
    {
      "name": "National Standards Release Centre",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.infoway-inforoute.ca"
        },
        {
          "system": "email",
          "value": "standards@infoway-inforoute.ca"
        }
      ]
    }
  ],
  "description": "This profile applies constraints to the Patient resource for CA Core+ to support identity, demographics, and administrative data in the pan-Canadian context.",
  "jurisdiction": [
    {
      "coding": [
        {
          "code": "CA",
          "system": "urn:iso:std:iso:3166"
        }
      ]
    }
  ],
  "copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "CACDI",
      "name": "Canadian Core Data for Interoperability (CACDI)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Patient",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Patient.extension",
        "path": "Patient.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Patient.extension:indigenousIdentity",
        "path": "Patient.extension",
        "sliceName": "indigenousIdentity",
        "short": "Extension for representing a code classifying a person's indigenous identity.",
        "definition": "A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-indigenousIdentity"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Indigenous Identity"
          }
        ]
      },
      {
        "id": "Patient.extension:racializedGroup",
        "path": "Patient.extension",
        "sliceName": "racializedGroup",
        "short": "Extension for representing a code classifying a person's racialized group.",
        "definition": "A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-racializedGroup"
            ]
          }
        ]
      },
      {
        "id": "Patient.extension:recordedSexOrGender",
        "path": "Patient.extension",
        "sliceName": "recordedSexOrGender",
        "short": "Recorded sex or gender (RSG) information includes the various sex and gender concepts.",
        "definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Gender Used"
          }
        ]
      },
      {
        "id": "Patient.extension:recordedSexOrGender.extension:value",
        "path": "Patient.extension.extension",
        "sliceName": "value"
      },
      {
        "id": "Patient.extension:recordedSexOrGender.extension:value.value[x]",
        "path": "Patient.extension.extension.value[x]",
        "binding": {
          "strength": "preferred",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgender"
        }
      },
      {
        "id": "Patient.extension:recordedSexOrGender.extension:type",
        "path": "Patient.extension.extension",
        "sliceName": "type"
      },
      {
        "id": "Patient.extension:recordedSexOrGender.extension:type.value[x]",
        "path": "Patient.extension.extension.value[x]",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "99502-7",
              "system": "http://loinc.org",
              "display": "Recorded sex or gender"
            }
          ]
        },
        "binding": {
          "strength": "required",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype"
        }
      },
      {
        "id": "Patient.extension:genderIdentity",
        "path": "Patient.extension",
        "sliceName": "genderIdentity",
        "short": "Extension for representing how the person prefers to self-describe.",
        "definition": "A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Gender Identity"
          }
        ]
      },
      {
        "id": "Patient.extension:genderIdentity.extension:value",
        "path": "Patient.extension.extension",
        "sliceName": "value"
      },
      {
        "id": "Patient.extension:genderIdentity.extension:value.value[x]",
        "path": "Patient.extension.extension.value[x]",
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode"
        }
      },
      {
        "id": "Patient.extension:pronouns",
        "path": "Patient.extension",
        "sliceName": "pronouns",
        "short": "Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)",
        "definition": "A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/individualPronouns"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Personal Pronouns"
          }
        ]
      },
      {
        "id": "Patient.extension:birthsex",
        "path": "Patient.extension",
        "sliceName": "birthsex",
        "short": "A code that specifies the sex of a person at birth which is a clinical finding",
        "definition": "A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-birthSex"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Sex at Birth"
          }
        ]
      },
      {
        "id": "Patient.extension:CommunicationBarrier",
        "path": "Patient.extension",
        "sliceName": "CommunicationBarrier",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/patient-communicationBarrier"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "type"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "requirements": "Patients are generally assigned specific alphanumeric identifiers."
      },
      {
        "id": "Patient.identifier.type",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.type",
        "example": [
          {
            "label": "Jurisdictional Health Number",
            "valueCodeableConcept": {
              "coding": [
                {
                  "code": "JHN",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            }
          },
          {
            "label": "Medical Record Number",
            "valueCodeableConcept": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            }
          },
          {
            "label": "Passport Number",
            "valueCodeableConcept": {
              "coding": [
                {
                  "code": "PPN",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            }
          },
          {
            "label": "National Unique Identifier (Placeholder Concept)",
            "valueCodeableConcept": {
              "coding": [
                {
                  "code": "NH",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            }
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Person Identifier Type"
          },
          {
            "identity": "CACDI",
            "map": "Party Non-Health Identifier Type"
          },
          {
            "identity": "CACDI",
            "map": "Patient Health Identifier Type"
          }
        ]
      },
      {
        "id": "Patient.identifier.system",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.system",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Party Non-Health Identifier System"
          },
          {
            "identity": "CACDI",
            "map": "Patient Health Identifier System"
          }
        ]
      },
      {
        "id": "Patient.identifier.value",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.value",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Person Identifier Value"
          },
          {
            "identity": "CACDI",
            "map": "Party Non-Health Identifier"
          },
          {
            "identity": "CACDI",
            "map": "Patient Health Identifier"
          }
        ]
      },
      {
        "id": "Patient.identifier.period.start",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.period.start",
        "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Party Non-Health Identifier Effective Date"
          },
          {
            "identity": "CACDI",
            "map": "Patient Health Identifier Effective Date"
          }
        ]
      },
      {
        "id": "Patient.identifier.period.end",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.period.end",
        "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Party Non-Health Identifier Expiry Date"
          },
          {
            "identity": "CACDI",
            "map": "Patient Health Identifier Expiry Date"
          }
        ]
      },
      {
        "id": "Patient.identifier.assigner",
        "path": "Patient.identifier.assigner",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Identifier Issuing Organization Code"
          }
        ]
      },
      {
        "id": "Patient.identifier:JHN",
        "path": "Patient.identifier",
        "sliceName": "JHN",
        "short": "Jurisdictional Health Number",
        "definition": "Patient and person health numbers used by all jurisdictions across Canada",
        "min": 0,
        "max": "*"
      },
      {
        "id": "Patient.identifier:JHN.extension:versionCode",
        "path": "Patient.identifier.extension",
        "sliceName": "versionCode",
        "short": "Health Number Version Code",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier:JHN.type",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.type",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "JHN",
              "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Patient.identifier:JHN.type.coding.display",
        "path": "Patient.identifier.type.coding.display",
        "comment": "This V2 Code has a display value of \"Jurisdictional Health Number\". Display values are not fixed to prevent errors when using this profile to validate a resource instance in a multilingual context or where the display may be different from its source."
      },
      {
        "id": "Patient.identifier:JHN.system",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.system",
        "short": "A Health Number Naming System from the Canadian URI Registry",
        "min": 1,
        "mustSupport": true,
        "binding": {
          "strength": "example",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/sharedpatientjurisdictionalhealthidentifiertype"
        }
      },
      {
        "id": "Patient.identifier:JHN.value",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Patient.identifier:MRN",
        "path": "Patient.identifier",
        "sliceName": "MRN",
        "short": "Medical Record Number",
        "definition": "A local patient identifier from the submitting PoS System",
        "comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
        "min": 0,
        "max": "*"
      },
      {
        "id": "Patient.identifier:MRN.type",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.type",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "MR",
              "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Patient.identifier:MRN.type.coding.display",
        "path": "Patient.identifier.type.coding.display",
        "comment": "This V2 Code has a display value of \"Medical Record Number\". Display values are not fixed to prevent errors when using this profile to validate a resource instance in a multilingual context or where the display may be different from its source."
      },
      {
        "id": "Patient.identifier:MRN.system",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.system",
        "short": "An identifier for the system supplying the MRN",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Patient.identifier:MRN.value",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.identifier.value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Patient.active",
        "path": "Patient.active",
        "comment": "it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients"
      },
      {
        "id": "Patient.name",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.name",
        "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
        "constraint": [
          {
            "key": "ca-core-pat-1",
            "human": "Either Patient.name.given and/or Patient.name.family SHALL be present.",
            "source": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
            "severity": "error",
            "expression": "(family.exists() or given.exists())",
            "xpath": "(/f:name/f:family or /f:name/f:given)"
          }
        ]
      },
      {
        "id": "Patient.name.use",
        "path": "Patient.name.use",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Name Used"
          },
          {
            "identity": "CACDI",
            "map": "Name Type"
          }
        ]
      },
      {
        "id": "Patient.name.text",
        "path": "Patient.name.text",
        "definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
        "comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance"
      },
      {
        "id": "Patient.name.family",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.name.family",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Surname"
          }
        ]
      },
      {
        "id": "Patient.name.given",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.name.given",
        "orderMeaning": "Patient.name.given[0] is expected to be the first name in a sequence. Patient.name.given[i], where i>0, is expected to express a Patient's middle name(s)",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Given Name"
          },
          {
            "identity": "CACDI",
            "map": "Middle Name"
          }
        ]
      },
      {
        "id": "Patient.name.period.start",
        "path": "Patient.name.period.start",
        "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)."
      },
      {
        "id": "Patient.name.period.end",
        "path": "Patient.name.period.end",
        "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)."
      },
      {
        "id": "Patient.telecom",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.telecom"
      },
      {
        "id": "Patient.telecom.system",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.telecom.system"
      },
      {
        "id": "Patient.telecom.value",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.telecom.value"
      },
      {
        "id": "Patient.telecom.use",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.telecom.use"
      },
      {
        "id": "Patient.gender",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.gender",
        "short": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.",
        "definition": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation."
      },
      {
        "id": "Patient.birthDate",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.birthDate",
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Date of Birth"
          }
        ]
      },
      {
        "id": "Patient.birthDate.extension",
        "path": "Patient.birthDate.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Patient.birthDate.extension:birthTime",
        "path": "Patient.birthDate.extension",
        "sliceName": "birthTime",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/patient-birthTime"
            ]
          }
        ]
      },
      {
        "id": "Patient.deceased[x]",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.deceased[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Patient.deceased[x]:deceasedDateTime",
        "path": "Patient.deceased[x]",
        "sliceName": "deceasedDateTime",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Date of Death"
          }
        ]
      },
      {
        "id": "Patient.address",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.address",
        "type": [
          {
            "code": "Address",
            "profile": [
              "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/address-ca-core"
            ]
          }
        ]
      },
      {
        "id": "Patient.address.line",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.address.line"
      },
      {
        "id": "Patient.address.postalCode",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.address.postalCode"
      },
      {
        "id": "Patient.address.country",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.address.country"
      },
      {
        "id": "Patient.contact.relationship",
        "path": "Patient.contact.relationship",
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/personalrelationshipcodes"
        }
      },
      {
        "id": "Patient.contact.name",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/obligation",
            "extension": [
              {
                "url": "code",
                "valueCode": "MAY:populate-if-known"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
              }
            ]
          },
          {
            "extension": [
              {
                "url": "code",
                "valueCode": "SHALL:no-error"
              },
              {
                "url": "actor",
                "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/obligation"
          }
        ],
        "path": "Patient.contact.name"
      },
      {
        "id": "Patient.communication",
        "path": "Patient.communication",
        "comment": "where applicable, SHOULD be used to identify the preferred communication language for the patient"
      },
      {
        "id": "Patient.communication.language",
        "path": "Patient.communication.language",
        "binding": {
          "strength": "preferred",
          "valueSet": "http://hl7.org/fhir/ValueSet/languages",
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
              "extension": [
                {
                  "url": "purpose",
                  "valueCode": "candidate"
                },
                {
                  "url": "valueSet",
                  "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/iso6393"
                },
                {
                  "url": "documentation",
                  "valueMarkdown": "ISO 639-3 Language Codes"
                }
              ]
            }
          ]
        },
        "mapping": [
          {
            "identity": "CACDI",
            "map": "Service Language"
          },
          {
            "identity": "CACDI",
            "map": "Party Role Service Language"
          }
        ]
      },
      {
        "id": "Patient.generalPractitioner",
        "path": "Patient.generalPractitioner",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
              "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
              "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
            ]
          }
        ]
      },
      {
        "id": "Patient.managingOrganization",
        "path": "Patient.managingOrganization",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
            ]
          }
        ]
      }
    ]
  }
}