{
  "resourceType": "StructureDefinition",
  "id": "49a569c7-2d16-4e5a-8e51-9cdb96b14573",
  "meta": {
    "versionId": "5",
    "lastUpdated": "2023-08-25T21:18:53.4308479+00:00"
  },
  "url": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-patient",
  "version": "1.0",
  "name": "ca-bc-careconnect-patient",
  "status": "active",
  "date": "2021-10-20T20:30:13.0990549+00:00",
  "fhirVersion": "3.0.2",
  "kind": "resource",
  "abstract": false,
  "type": "Patient",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Patient",
        "path": "Patient",
        "short": "Information about an individual receiving health care services",
        "definition": "Demographics and other administrative information about an individual receiving care or other health-related services.\r\nPatient demographics are based on client records in EMPI, BC client registry; however a subset of patient data from local source systems is included as contained resources with a relationship as \"refer\" to the main record of Patient."
      },
      {
        "id": "Patient.id",
        "path": "Patient.id",
        "min": 1
      },
      {
        "id": "Patient.meta",
        "path": "Patient.meta",
        "max": "0"
      },
      {
        "id": "Patient.implicitRules",
        "path": "Patient.implicitRules",
        "max": "0"
      },
      {
        "id": "Patient.language",
        "path": "Patient.language",
        "max": "0"
      },
      {
        "id": "Patient.text",
        "path": "Patient.text",
        "max": "0"
      },
      {
        "id": "Patient.extension",
        "path": "Patient.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.extension:calculatedAge",
        "path": "Patient.extension",
        "sliceName": "calculatedAge",
        "comment": "CalculatedAge is based on the patient's birthDate and deceasedDateTime if available otherwise the current system datetime.",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-calculated-age-extension"
          }
        ]
      },
      {
        "id": "Patient.identifier",
        "path": "Patient.identifier",
        "comment": "Identifiers could be the patient's BC PHNs or local MRNs as stored in EMPI.\r\nPreviously used identifiers are marked with the isHistorical extension."
      },
      {
        "id": "Patient.identifier.extension",
        "path": "Patient.identifier.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.identifier.extension:isHistorical",
        "path": "Patient.identifier.extension",
        "sliceName": "isHistorical",
        "definition": "Optional Extension Element - found in all resources.\r\nThis boolean flag indicates the data is not current but provided for reference only.",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-is-historical-indicator-extension"
          }
        ]
      },
      {
        "id": "Patient.identifier.use",
        "path": "Patient.identifier.use",
        "definition": "The purpose of this identifier.\r\nOnly the patient's current active BC PHN is marked as \"official\"; others are marked as \"usual\"."
      },
      {
        "id": "Patient.identifier.type.id",
        "path": "Patient.identifier.type.id",
        "max": "0"
      },
      {
        "id": "Patient.identifier.type.coding.id",
        "path": "Patient.identifier.type.coding.id",
        "max": "0"
      },
      {
        "id": "Patient.identifier.type.coding.version",
        "path": "Patient.identifier.type.coding.version",
        "max": "0"
      },
      {
        "id": "Patient.identifier.type.coding.code",
        "path": "Patient.identifier.type.coding.code",
        "fixedCode": "MR"
      },
      {
        "id": "Patient.identifier.type.coding.display",
        "path": "Patient.identifier.type.coding.display",
        "fixedString": "Medical record number"
      },
      {
        "id": "Patient.identifier.type.coding.userSelected",
        "path": "Patient.identifier.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Patient.identifier.type.text",
        "path": "Patient.identifier.type.text",
        "max": "0"
      },
      {
        "id": "Patient.identifier.period",
        "path": "Patient.identifier.period",
        "max": "0"
      },
      {
        "id": "Patient.identifier.assigner",
        "path": "Patient.identifier.assigner",
        "max": "0"
      },
      {
        "id": "Patient.identifier.assigner.id",
        "path": "Patient.identifier.assigner.id",
        "max": "0"
      },
      {
        "id": "Patient.identifier.assigner.reference",
        "path": "Patient.identifier.assigner.reference",
        "max": "0"
      },
      {
        "id": "Patient.identifier.assigner.identifier",
        "path": "Patient.identifier.assigner.identifier",
        "max": "0"
      },
      {
        "id": "Patient.active",
        "path": "Patient.active",
        "max": "0"
      },
      {
        "id": "Patient.name",
        "path": "Patient.name",
        "comment": "A patient may have multiple names with different uses or applicable periods. \r\nPreviously used names are marked with the isHistorical extension."
      },
      {
        "id": "Patient.name.extension",
        "path": "Patient.name.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.name.extension:isHistorical",
        "path": "Patient.name.extension",
        "sliceName": "isHistorical",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-is-historical-indicator-extension"
          }
        ]
      },
      {
        "id": "Patient.name.text",
        "path": "Patient.name.text",
        "max": "0"
      },
      {
        "id": "Patient.name.given.extension",
        "path": "Patient.name.given.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.name.given.extension:iso21090-EN-qualifier",
        "path": "Patient.name.given.extension",
        "sliceName": "iso21090-EN-qualifier",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier"
          }
        ]
      },
      {
        "id": "Patient.name.prefix",
        "path": "Patient.name.prefix",
        "max": "0"
      },
      {
        "id": "Patient.name.suffix",
        "path": "Patient.name.suffix",
        "max": "0"
      },
      {
        "id": "Patient.name.period",
        "path": "Patient.name.period",
        "max": "0"
      },
      {
        "id": "Patient.name.period.id",
        "path": "Patient.name.period.id",
        "max": "0"
      },
      {
        "id": "Patient.name.period.start",
        "path": "Patient.name.period.start",
        "max": "0"
      },
      {
        "id": "Patient.telecom",
        "path": "Patient.telecom",
        "comment": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).\r\nPreviously used contact information are marked with the isHistorical extension."
      },
      {
        "id": "Patient.telecom.extension",
        "path": "Patient.telecom.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.telecom.extension:sourceSystem",
        "path": "Patient.telecom.extension",
        "sliceName": "sourceSystem",
        "short": "Extension on Telecom to catch contact point where no type or system is provided",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-TEL-address"
          }
        ]
      },
      {
        "id": "Patient.telecom.extension:sourceSystem.valueString:valueString",
        "path": "Patient.telecom.extension.valueString",
        "sliceName": "valueString",
        "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).\r\nThis is the telecom type as received from source system without any translation or mappings."
      },
      {
        "id": "Patient.telecom.extension:isHistorical",
        "path": "Patient.telecom.extension",
        "sliceName": "isHistorical",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-is-historical-indicator-extension"
          }
        ]
      },
      {
        "id": "Patient.telecom.rank",
        "path": "Patient.telecom.rank",
        "max": "0"
      },
      {
        "id": "Patient.telecom.period",
        "path": "Patient.telecom.period",
        "max": "0"
      },
      {
        "id": "Patient.telecom.period.id",
        "path": "Patient.telecom.period.id",
        "max": "0"
      },
      {
        "id": "Patient.telecom.period.end",
        "path": "Patient.telecom.period.end",
        "max": "0"
      },
      {
        "id": "Patient.gender",
        "path": "Patient.gender",
        "definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.\r\nThis is the current gender the patient is referred to, as is stored in EMPI."
      },
      {
        "id": "Patient.deceased[x]:deceasedDateTime",
        "path": "Patient.deceasedDateTime",
        "sliceName": "deceasedDateTime",
        "short": "Date and time when the individual is deceased",
        "definition": "The individual's deceased datetime.",
        "type": [
          {
            "code": "dateTime"
          }
        ]
      },
      {
        "id": "Patient.address",
        "path": "Patient.address",
        "definition": "Addresses for the individual as stored in EMPI."
      },
      {
        "id": "Patient.address.extension",
        "path": "Patient.address.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.address.extension:isHstorical",
        "path": "Patient.address.extension",
        "sliceName": "isHstorical",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-is-historical-indicator-extension"
          }
        ]
      },
      {
        "id": "Patient.address.extension:isVerified",
        "path": "Patient.address.extension",
        "sliceName": "isVerified",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-is-verified-indicator-extension"
          }
        ]
      },
      {
        "id": "Patient.address.use",
        "path": "Patient.address.use",
        "max": "0"
      },
      {
        "id": "Patient.address.text",
        "path": "Patient.address.text",
        "max": "0"
      },
      {
        "id": "Patient.address.district",
        "path": "Patient.address.district",
        "max": "0"
      },
      {
        "id": "Patient.address.period",
        "path": "Patient.address.period",
        "max": "0"
      },
      {
        "id": "Patient.address.period.id",
        "path": "Patient.address.period.id",
        "max": "0"
      },
      {
        "id": "Patient.address.period.end",
        "path": "Patient.address.period.end",
        "max": "0"
      },
      {
        "id": "Patient.maritalStatus",
        "path": "Patient.maritalStatus",
        "max": "0"
      },
      {
        "id": "Patient.multipleBirth[x]:multipleBirthInteger",
        "path": "Patient.multipleBirthInteger",
        "sliceName": "multipleBirthInteger",
        "definition": "Indicates the actual birth order (integer).",
        "type": [
          {
            "code": "integer"
          }
        ]
      },
      {
        "id": "Patient.photo",
        "path": "Patient.photo",
        "max": "0"
      },
      {
        "id": "Patient.contact.id",
        "path": "Patient.contact.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.relationship.id",
        "path": "Patient.contact.relationship.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.relationship.coding.id",
        "path": "Patient.contact.relationship.coding.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.relationship.coding.version",
        "path": "Patient.contact.relationship.coding.version",
        "max": "0"
      },
      {
        "id": "Patient.contact.relationship.coding.userSelected",
        "path": "Patient.contact.relationship.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Patient.contact.name.id",
        "path": "Patient.contact.name.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.name.text",
        "path": "Patient.contact.name.text",
        "max": "0"
      },
      {
        "id": "Patient.contact.name.prefix",
        "path": "Patient.contact.name.prefix",
        "max": "0"
      },
      {
        "id": "Patient.contact.name.suffix",
        "path": "Patient.contact.name.suffix",
        "max": "0"
      },
      {
        "id": "Patient.contact.name.period",
        "path": "Patient.contact.name.period",
        "max": "0"
      },
      {
        "id": "Patient.contact.telecom.extension",
        "path": "Patient.contact.telecom.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.contact.telecom.extension:sourceType",
        "path": "Patient.contact.telecom.extension",
        "sliceName": "sourceType",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-TEL-address"
          }
        ]
      },
      {
        "id": "Patient.contact.telecom.use",
        "path": "Patient.contact.telecom.use",
        "max": "0"
      },
      {
        "id": "Patient.contact.telecom.rank",
        "path": "Patient.contact.telecom.rank",
        "max": "0"
      },
      {
        "id": "Patient.contact.telecom.period",
        "path": "Patient.contact.telecom.period",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.id",
        "path": "Patient.contact.address.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.use",
        "path": "Patient.contact.address.use",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.type",
        "path": "Patient.contact.address.type",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.text",
        "path": "Patient.contact.address.text",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.district",
        "path": "Patient.contact.address.district",
        "max": "0"
      },
      {
        "id": "Patient.contact.address.period",
        "path": "Patient.contact.address.period",
        "max": "0"
      },
      {
        "id": "Patient.contact.gender",
        "path": "Patient.contact.gender",
        "max": "0"
      },
      {
        "id": "Patient.contact.organization",
        "path": "Patient.contact.organization",
        "max": "0"
      },
      {
        "id": "Patient.contact.period.id",
        "path": "Patient.contact.period.id",
        "max": "0"
      },
      {
        "id": "Patient.contact.period.start",
        "path": "Patient.contact.period.start",
        "max": "0"
      },
      {
        "id": "Patient.animal",
        "path": "Patient.animal",
        "max": "0"
      },
      {
        "id": "Patient.communication.id",
        "path": "Patient.communication.id",
        "max": "0"
      },
      {
        "id": "Patient.communication.language.extension",
        "path": "Patient.communication.language.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Patient.communication.language.extension:lastReceivedDate",
        "path": "Patient.communication.language.extension",
        "sliceName": "lastReceivedDate",
        "comment": "Date element value was last received from source system.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir.healthbc.org/StructureDefinition/ca-bc-careconnect-last-modified-date-extension"
          }
        ]
      },
      {
        "id": "Patient.communication.language.coding",
        "path": "Patient.communication.language.coding",
        "max": "0"
      },
      {
        "id": "Patient.communication.language.coding.id",
        "path": "Patient.communication.language.coding.id",
        "max": "0"
      },
      {
        "id": "Patient.communication.language.coding.version",
        "path": "Patient.communication.language.coding.version",
        "max": "0"
      },
      {
        "id": "Patient.communication.language.coding.userSelected",
        "path": "Patient.communication.language.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Patient.communication.language.text",
        "path": "Patient.communication.language.text",
        "min": 1
      },
      {
        "id": "Patient.communication.preferred",
        "path": "Patient.communication.preferred",
        "max": "0"
      },
      {
        "id": "Patient.generalPractitioner",
        "path": "Patient.generalPractitioner",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner",
            "aggregation": [
              "contained"
            ]
          }
        ]
      },
      {
        "id": "Patient.managingOrganization",
        "path": "Patient.managingOrganization",
        "max": "0"
      },
      {
        "id": "Patient.link",
        "path": "Patient.link",
        "comment": "The link.type is defined as \"refer\" which means this patient should be treated as a reference or \"refer\" to for additional details.\r\nWhile the main Patient resource is based on patient data set in EMPI, the linked patient is based on the locally stored patient from various source systems that provide CareConect the ADT encounters and CDA documents. \r\n\r\nThe referring patient must match the main patient by \r\na) BC PHN or local MRN if source system is not integrated with EMPI, and \r\nb) first five alpha characters in the last name, and \r\nc) the birth year and month (YYYYMM).",
        "requirements": "Distribution of patient information across multiple servers."
      },
      {
        "id": "Patient.link.id",
        "path": "Patient.link.id",
        "max": "0"
      },
      {
        "id": "Patient.link.other",
        "path": "Patient.link.other",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient",
            "aggregation": [
              "contained"
            ]
          }
        ]
      },
      {
        "id": "Patient.link.other.id",
        "path": "Patient.link.other.id",
        "max": "0"
      },
      {
        "id": "Patient.link.other.reference.id",
        "path": "Patient.link.other.reference.id",
        "max": "0"
      },
      {
        "id": "Patient.link.other.identifier",
        "path": "Patient.link.other.identifier",
        "max": "0"
      },
      {
        "id": "Patient.link.other.display",
        "path": "Patient.link.other.display",
        "max": "0"
      },
      {
        "id": "Patient.link.type",
        "path": "Patient.link.type",
        "fixedCode": "refer"
      }
    ]
  }
}