BCY Immunization Distribution Service Implementation Guide

Patient_CAbaseline

The FHIR resource Patient is based on Canadian baseline.

Patient_CAbaseline (Patient)	I		Patient	Element id Patient Short description IFHIR resource applies for PIR Client Alternate names SubjectOfCare Client Resident Definition IFHIR resource applies for PIR Client Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
id	Σ	1..1	string	Element id Patient.id Short description PIR Client ID Definition Unique Panorama Client ID Comments See Mappings Data type string Mappings source-PIR: PIR subject_id
meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Patient.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
versionId	Σ	0..1	id	Element id Patient.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2025.01.1' (This indicates the FHIR Specs changes on 2025 - Jan) Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastUpdated	Σ	0..1	instant	Element id Patient.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
source	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
profile	Σ	1..1	canonical(StructureDefinition)	Element id Patient.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient' Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Patient.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id Patient.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..1	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
genderIdentityExtension	I	0..*	Extension(CodeableConcept)	Element id Patient.extension:genderIdentityExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	1..*	Identifier	Element id Patient.identifier Short description Identifier(s) for this patient Definition Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN), PI (Patient Internal Identifier e.g. PIR Client ID, HAs' Internal Client ID). Requirements Patients are almost always assigned specific numerical identifiers. Comments Extract from PIR <client.human_subject> Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Patient.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uriFixed Value	Element id Patient.identifier.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments http://terminology.hl7.org/CodeSystem/v2-0203 Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://terminology.hl7.org/CodeSystem/v2-0203 Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	Element id Patient.identifier.type.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code JHN: JHN JPID: JPID MR: MR PI: PI
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Patient.identifier.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	Element id Patient.identifier.type.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Panorama Client ID source-FHA: FHA-PARIS Client ID source-NHA-CeDaR: NHA- CeDaR ID source-NHA-MOIS: NHA - MOIS ID source-VCH: VCH-PARIS Client ID source-ProfileEMR: ProfileEMR_ClientID source-CAN-ArmedForces: Canadian Armed Forces IDentification Number source-CAN-RCMP: Canadian RCMP Regiment Number source-CAN-VeteranAffairs: Veteran Affairs CAnadian Identification Number
system	Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings below for appropriate URLs and URNs. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType JHN-BC: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id PI-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id JHN-YT: https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id PI-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id PI-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id PI-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id PI-CAN-ArmedForces: urn: 2.16.840.1.113883.3.51.1.1.6.15 PI-RCMP: urn:2.16.840.1.113883.3.51.1.1.6.16 PI-CAN-VeteranAffairs: urn:2.16.840.1.113883.3.51.1.1.6.18 PI-ProfileEMR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id
value	Σ	1..1	string	Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number) Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value JHN-BC: Extract from PIR (client.human_subject.health_card_number) JHN-YT: Extract from PIR (client.human_subject.health_card_number) PI-PIR: Extract from PIR (client.human_subject.subject_id) PI-FHA: FHA-PARIS Client ID PI-NHA: NHA- CeDaR ID PI-VCH: VCH-PARIS Client ID
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
active	Σ ?!	1..1	boolean	Element id Patient.active Short description Whether this patient's record is in active use in PIR. Definition It is used to filter patient lists to exclude inactive patients Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased). Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments Hardcode as 'True' for all PIR active clients. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition PIR Client Lastname, Firstname, Middlename Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments Extract from PIR <client.human_subject> Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments See Mappings Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose legal: official alias: usual
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: implied by XPN.11 rim: ./formatted
family	Σ	1..1	string	Element id Patient.name.family Short description Patient Family Name Alternate names surname Definition Patient Family Name Comments Patient Family Name Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
given	Σ	1..*	string	Element id Patient.name.given Short description Patient Given Names Alternate names first name, middle name Definition Patient Given Names Comments Patient Given Names Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
prefix	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN/4 rim: ./part[partType = SFX]
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	Σ	0..*	ContactPoint	Element id Patient.telecom Short description A contact detail for the PIR Client Definition A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments 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 might 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ I	0..1	codeBinding	Element id Patient.telecom.system Short description phone \| fax \| email \| pager \| url \| sms \| other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Comments Use 'phone \| email'. Extract the current phone or email from PIR, not the ones with 'Effective Date To' populated. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.3 rim: ./scheme servd: ./ContactPointType
value	Σ	0..1	string	Element id Patient.telecom.value Short description Patient Phone Number or Email Definition Patient Phone Number or Email Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Patient Phone Number \| Email Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
use	Σ ?!	0..1	codeBinding	Element id Patient.telecom.use Short description home \| work \| mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments Use "home" \| "work" \|"mobile" (See Mappings). If not listed in the mappings, drop the attirubte USE, do not send. Data type code Binding Use of contact point. ContactPointUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose pirHOME: home pirBUSINESS: work pirMOBILE: mobile
rank	Σ	0..0	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: n/a rim: n/a
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
gender	Σ	1..1	codeBinding	Element id Patient.gender Short description male \| female \| other \| unknown Definition Patient Administrative Gender. PIR gender "Undifferentiate" is mapped to "unknown" in FHIR. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments Patient Administrative Gender Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
id		0..0	string	There are no (further) constraints on this element Element id Patient.gender.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.gender.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
value		0..1	System.String	There are no (further) constraints on this element Element id Patient.gender.value Short description Primitive value for code Definition Primitive value for code Data type System.String
birthDate	Σ	1..1	date	Element id Patient.birthDate Short description Patient Date of Birth Definition Patient Date of Birth Requirements Age of the individual drives many clinical processes. Comments Patient Date of Birth (yyyy-mm-dd) Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
deceased[x]	Σ ?!	0..1		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	Σ	0..1	Address	Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Extract the LATEST client address from PIR Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr
id		0..1	string	There are no (further) constraints on this element Element id Patient.address.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	Element id Patient.address.use Short description home \| work \| temp \| old \| billing - purpose of this address Definition The purpose of this address: home \| work Requirements Allows an appropriate address to be chosen from a list of many. Comments See Mappings Data type code Binding The use of an address. AddressUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General home Mappings v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose pir-PrimaryHome: home
type	Σ	0..1	codeBinding	Element id Patient.address.type Short description postal \| physical \| both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Comments See Mappings. Data type code Binding The type of an address (physical / postal). AddressType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General both Mappings v2: XAD.18 rim: unique(./use) vcard: address type parameter pir-PostalAddress: postal
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street, Erewhon 9132 Mappings v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
line	Σ	0..*	string	Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Comments Use address.line for international address Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street Mappings v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim: AD.part[parttype = AL] vcard: street servd: ./StreetAddress (newline delimitted)
id		0..1	string	There are no (further) constraints on this element Element id Patient.address.line.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	Element id Patient.address.line.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
_line	I	0..1	Extension(string)	Element id Patient.address.line.extension:_line Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments See Mappings Data type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A houseNumber: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber streetName: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName streetNameType: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetNameType direction: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-direction unitID: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
value		0..1	System.String	There are no (further) constraints on this element Element id Patient.address.line.value Short description Primitive value for string Definition The actual value Data type System.String Maximum string length 1048576
city	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Erewhon Mappings v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
district	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Madison Mappings v2: XAD.9 rim: AD.part[parttype = CNT \| CPA]
state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description Sub-unit of country (abbreviations ok) Alternate names Province, Territory Definition Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
postalCode	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 9132 Mappings v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
country	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted. Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo		0..1	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-2 rim: name cda: n/a
telecom		0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact 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. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
organization	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period		0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: effectiveTime cda: n/a
communication		0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
preferred		0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner		0..1	Reference(Organization \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Data type Reference(Organization \| Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
managingOrganization	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
other	Σ	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-3, MRG-1 rim: id cda: n/a
id		0..0	string	There are no (further) constraints on this element Element id Patient.link.other.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.other.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	Σ I	1..1	string	Element id Patient.link.other.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A resrouceType-PIRID: fullURL of Panorama + 'Patient' + <PIR Client ID>
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Patient.link.other.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Patient.link.other.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.link.other.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	1..1	codeBinding	Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso Definition Use 'replaces' for resourcePatient as the survivor patient out of a merge. Comments "replaces" non-survivor patient id with survivor patient id. Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: typeCode cda: n/a

Patient
Definition	IFHIR resource applies for PIR Client
Cardinality	0...*
Alias	SubjectOfCare Client Resident
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists()
Mappings	rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
Patient.id
Definition	Unique Panorama Client ID
Cardinality	1...1
Type	string
Summary	True
Comments	See Mappings
Mappings	source-PIR: PIR subject_id
Patient.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality	1...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.meta.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.meta.versionId
Definition	The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Cardinality	0...1
Type	id
Summary	True
Comments	Apply '2025.01.1' (This indicates the FHIR Specs changes on 2025 - Jan)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.lastUpdated
Definition	When the resource last changed - e.g. when the version changed.
Cardinality	0...1
Type	instant
Summary	True
Comments	Updated: Relax the previously crossed-out elements.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.source
Definition	A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Cardinality	0...1
Type	uri
Summary	True
Comments	In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.profile
Definition	A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
Cardinality	1...1
Type	canonical(StructureDefinition)
Summary	True
Comments	Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient'
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.security
Definition	Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality	0...1
Type	Coding
Binding	Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)
Summary	True
Comments	The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.meta.tag
Definition	Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality	0...1
Type	Coding
Binding	Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)
Summary	True
Comments	The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Patient.text
Definition	A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
Patient.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality	0...1
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Mappings	rim: N/A
Patient.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Patient.extension:genderIdentityExtension
Definition	Optional Extension Element - found in all resources.
Cardinality	0...*
Type	Extension(CodeableConcept)
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A rim: n/a
Patient.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Patient.identifier
Definition	Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN), PI (Patient Internal Identifier e.g. PIR Client ID, HAs' Internal Client ID).
Cardinality	1...*
Type	Identifier
Summary	True
Requirements	Patients are almost always assigned specific numerical identifiers.
Comments	Extract from PIR <client.human_subject>
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
Patient.identifier.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.identifier.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.identifier.use
Definition	The purpose of this identifier.
Cardinality	0...1
Type	code
Binding	Identifies the purpose for this identifier, if known . IdentifierUse (required)
Modifier	True
Summary	True
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: N/A rim: Role.code or implied by context
Patient.identifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality	1...1
Type	CodeableConcept
Binding	A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)
Summary	True
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.5 rim: Role.code or implied by context
Patient.identifier.type.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.identifier.type.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.identifier.type.coding
Definition	A reference to a code defined by a terminology system.
Cardinality	1...*
Type	Coding
Summary	True
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Patient.identifier.type.coding.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.identifier.type.coding.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.identifier.type.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	0...1
Type	uri
Summary	True
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Comments	http://terminology.hl7.org/CodeSystem/v2-0203
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	http://terminology.hl7.org/CodeSystem/v2-0203
Mappings	v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Patient.identifier.type.coding.version
Definition	The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality	0...1
Type	string
Summary	True
Comments	Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Patient.identifier.type.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality	0...1
Type	code
Summary	True
Requirements	Need to refer to a particular code in the system.
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code JHN: JHN JPID: JPID MR: MR PI: PI
Patient.identifier.type.coding.display
Definition	A representation of the meaning of the code in the system, following the rules of the system.
Cardinality	0...1
Type	string
Summary	True
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Patient.identifier.type.coding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0...1
Type	boolean
Summary	True
Requirements	This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments	Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Patient.identifier.type.text
Definition	A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality	0...1
Type	string
Summary	True
Requirements	The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Panorama Client ID source-FHA: FHA-PARIS Client ID source-NHA-CeDaR: NHA- CeDaR ID source-NHA-MOIS: NHA - MOIS ID source-VCH: VCH-PARIS Client ID source-ProfileEMR: ProfileEMR_ClientID source-CAN-ArmedForces: Canadian Armed Forces IDentification Number source-CAN-RCMP: Canadian RCMP Regiment Number source-CAN-VeteranAffairs: Veteran Affairs CAnadian Identification Number
Patient.identifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality	1...1
Type	uri
Summary	True
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments	See Mappings below for appropriate URLs and URNs.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General http://www.acme.com/identifiers/patient
Mappings	v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType JHN-BC: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id PI-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id JHN-YT: https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id PI-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id PI-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id PI-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id PI-CAN-ArmedForces: urn: 2.16.840.1.113883.3.51.1.1.6.15 PI-RCMP: urn:2.16.840.1.113883.3.51.1.1.6.16 PI-CAN-VeteranAffairs: urn:2.16.840.1.113883.3.51.1.1.6.18 PI-ProfileEMR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id
Patient.identifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality	1...1
Type	string
Summary	True
Comments	PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 123456
Mappings	v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value JHN-BC: Extract from PIR (client.human_subject.health_card_number) JHN-YT: Extract from PIR (client.human_subject.health_card_number) PI-PIR: Extract from PIR (client.human_subject.subject_id) PI-FHA: FHA-PARIS Client ID PI-NHA: NHA- CeDaR ID PI-VCH: VCH-PARIS Client ID
Patient.identifier.period
Definition	Time period during which identifier is/was valid for use.
Cardinality	0...1
Type	Period
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
Patient.identifier.assigner
Definition	Organization that issued/manages the identifier.
Cardinality	0...1
Type	Reference(Organization)
Summary	True
Comments	The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
Patient.active
Definition	It is used to filter patient lists to exclude inactive patients Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased).
Cardinality	1...1
Type	boolean
Modifier	True
Summary	True
Requirements	Need to be able to mark a patient record as not to be used because it was created in error.
Comments	Hardcode as 'True' for all PIR active clients.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.status rim: statusCode cda: n/a
Patient.name
Definition	PIR Client Lastname, Firstname, Middlename
Cardinality	1...*
Type	HumanName
Summary	True
Requirements	Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Comments	Extract from PIR <client.human_subject>
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-5, PID-9 rim: name cda: .patient.name
Patient.name.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.name.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.name.use
Definition	Identifies the purpose for this name.
Cardinality	0...1
Type	code
Binding	The use of a human name. NameUse (required)
Modifier	True
Summary	True
Requirements	Allows the appropriate name for a particular context of use to be selected from among a set of names.
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose legal: official alias: usual
Patient.name.text
Definition	Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
Cardinality	0...1
Type	string
Summary	True
Requirements	A renderable, unencoded form.
Comments	Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: implied by XPN.11 rim: ./formatted
Patient.name.family
Definition	Patient Family Name
Cardinality	1...1
Type	string
Summary	True
Alias	surname
Comments	Patient Family Name
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
Patient.name.given
Definition	Patient Given Names
Cardinality	1...*
Type	string
Summary	True
Alias	first name, middle name
Comments	Patient Given Names
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
Patient.name.prefix
Definition	Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.
Cardinality	0...1
Type	string
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
Patient.name.suffix
Definition	Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.
Cardinality	0...1
Type	string
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN/4 rim: ./part[partType = SFX]
Patient.name.period
Definition	Indicates the period of time when this name was valid for the named person.
Cardinality	0...1
Type	Period
Summary	True
Requirements	Allows names to be placed in historical context.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
Patient.telecom
Definition	A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted.
Cardinality	0...*
Type	ContactPoint
Summary	True
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Comments	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 might 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).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
Patient.telecom.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...0
Type	string
Mappings	rim: n/a
Patient.telecom.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.telecom.system
Definition	Telecommunications form for contact point - what communications system is required to make use of the contact.
Cardinality	0...1
Type	code
Binding	Telecommunications form for contact point. ContactPointSystem (required)
Summary	True
Comments	Use 'phone \| email'. Extract the current phone or email from PIR, not the ones with 'Effective Date To' populated.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XTN.3 rim: ./scheme servd: ./ContactPointType
Patient.telecom.value
Definition	Patient Phone Number or Email
Cardinality	0...1
Type	string
Summary	True
Requirements	Need to support legacy numbers that are not in a tightly controlled format.
Comments	Patient Phone Number \| Email
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
Patient.telecom.use
Definition	Identifies the purpose for the contact point.
Cardinality	0...1
Type	code
Binding	Use of contact point. ContactPointUse (required)
Modifier	True
Summary	True
Requirements	Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Comments	Use "home" \| "work" \|"mobile" (See Mappings). If not listed in the mappings, drop the attirubte USE, do not send.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose pirHOME: home pirBUSINESS: work pirMOBILE: mobile
Patient.telecom.rank
Definition	Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Cardinality	0...0
Type	positiveInt
Summary	True
Comments	Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: n/a rim: n/a
Patient.telecom.period
Definition	Time period when the contact point was/is in use.
Cardinality	0...1
Type	Period
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
Patient.telecom.period.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...0
Type	string
Mappings	rim: n/a
Patient.telecom.period.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.telecom.period.start
Definition	The start of the period. The boundary is inclusive.
Cardinality	0...1
Type	dateTime
Summary	True
Comments	If the low element is missing, the meaning is that the low boundary is not known.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: DR.1 rim: ./low
Patient.telecom.period.end
Definition	The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality	0...1
Type	dateTime
Summary	True
Comments	The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: DR.2 rim: ./high
Patient.gender
Definition	Patient Administrative Gender. PIR gender "Undifferentiate" is mapped to "unknown" in FHIR.
Cardinality	1...1
Type	code
Binding	The gender of a person used for administrative purposes. AdministrativeGender (required)
Summary	True
Requirements	Needed for identification of the individual, in combination with (at least) name and birth date.
Comments	Patient Administrative Gender
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
Patient.gender.id
Definition	unique id for the element within a resource (for internal references)
Cardinality	0...0
Type	string
Patient.gender.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Patient.gender.value
Definition	Primitive value for code
Cardinality	0...1
Type	System.String
Patient.birthDate
Definition	Patient Date of Birth
Cardinality	1...1
Type	date
Summary	True
Requirements	Age of the individual drives many clinical processes.
Comments	Patient Date of Birth (yyyy-mm-dd)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
Patient.deceased[x]
Definition	Indicates if the individual is deceased or not.
Cardinality	0...1
Type	boolean
Modifier	True
Summary	True
Requirements	The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Comments	If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
Patient.address
Definition	An address for the individual.
Cardinality	0...1
Type	Address
Summary	True
Requirements	May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Comments	Extract the LATEST client address from PIR
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-11 rim: addr cda: .addr
Patient.address.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.address.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.address.use
Definition	The purpose of this address: home \| work
Cardinality	0...1
Type	code
Binding	The use of an address. AddressUse (required)
Modifier	True
Summary	True
Requirements	Allows an appropriate address to be chosen from a list of many.
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General home
Mappings	v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose pir-PrimaryHome: home
Patient.address.type
Definition	Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
Cardinality	0...1
Type	code
Binding	The type of an address (physical / postal). AddressType (required)
Summary	True
Comments	See Mappings.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General both
Mappings	v2: XAD.18 rim: unique(./use) vcard: address type parameter pir-PostalAddress: postal
Patient.address.text
Definition	Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
Cardinality	0...1
Type	string
Summary	True
Requirements	A renderable, unencoded form.
Comments	Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 137 Nowhere Street, Erewhon 9132
Mappings	v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
Patient.address.line
Definition	This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Cardinality	0...*
Type	string
Summary	True
Comments	Use address.line for international address
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 137 Nowhere Street
Mappings	v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim: AD.part[parttype = AL] vcard: street servd: ./StreetAddress (newline delimitted)
Patient.address.line.id
Definition	unique id for the element within a resource (for internal references)
Cardinality	0...1
Type	string
Patient.address.line.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Patient.address.line.extension:_line
Definition	Optional Extension Element - found in all resources.
Cardinality	0...1
Type	Extension(string)
Alias	extensions, user content
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A houseNumber: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber streetName: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName streetNameType: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetNameType direction: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-direction unitID: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
Patient.address.line.value
Definition	The actual value
Cardinality	0...1
Type	System.String
Patient.address.city
Definition	The name of the city, town, suburb, village or other community or delivery center.
Cardinality	0...1
Type	string
Summary	True
Alias	Municpality
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General Erewhon
Mappings	v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
Patient.address.district
Definition	The name of the administrative area (county).
Cardinality	0...1
Type	string
Summary	True
Alias	County
Comments	District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General Madison
Mappings	v2: XAD.9 rim: AD.part[parttype = CNT \| CPA]
Patient.address.state
Definition	Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
Cardinality	0...1
Type	string
Summary	True
Alias	Province, Territory
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
Patient.address.postalCode
Definition	A postal code designating a region defined by the postal service.
Cardinality	0...1
Type	string
Summary	True
Alias	Zip
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 9132
Mappings	v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
Patient.address.country
Definition	Country - a nation as commonly understood or generally accepted.
Cardinality	0...1
Type	string
Summary	True
Comments	ISO 3166 3 letter codes can be used in place of a human readable country name.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
Patient.address.period
Definition	Time period when address was/is in use.
Cardinality	0...1
Type	Period
Summary	True
Requirements	Allows addresses to be placed in historical context.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General { "start": "2010-03-23", "end": "2010-07-01" }
Mappings	v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
Patient.maritalStatus
Definition	This field contains a patient's most recent marital (civil) status.
Cardinality	0...1
Type	CodeableConcept
Binding	The domestic partnership status of a person. Marital Status Codes (extensible)
Requirements	Most, if not all systems capture it.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
Patient.multipleBirth[x]
Definition	Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Cardinality	0...1
Type	boolean
Requirements	For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Comments	Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
Patient.photo
Definition	Image of the patient.
Cardinality	0...1
Type	Attachment
Requirements	Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Comments	Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
Patient.contact
Definition	A contact party (e.g. guardian, partner, friend) for the patient.
Cardinality	0...1
Type	BackboneElement
Requirements	Need to track people you can contact about the patient.
Comments	Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()`
Mappings	rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
Patient.contact.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.contact.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.contact.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Patient.contact.relationship
Definition	The nature of the relationship between the patient and the contact person.
Cardinality	0...*
Type	CodeableConcept
Binding	The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible)
Requirements	Used to determine which contact person is the most relevant to approach, depending on circumstances.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-7, NK1-3 rim: code cda: n/a
Patient.contact.name
Definition	A name associated with the contact person.
Cardinality	0...1
Type	HumanName
Requirements	Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-2 rim: name cda: n/a
Patient.contact.telecom
Definition	A contact detail for the person, e.g. a telephone number or an email address.
Cardinality	0...*
Type	ContactPoint
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Comments	Contact 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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
Patient.contact.address
Definition	Address for the contact person.
Cardinality	0...1
Type	Address
Requirements	Need to keep track where the contact person can be contacted per postal mail or visited.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-4 rim: addr cda: n/a
Patient.contact.gender
Definition	Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Cardinality	0...1
Type	code
Binding	The gender of a person used for administrative purposes. AdministrativeGender (required)
Requirements	Needed to address the person correctly.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
Patient.contact.organization
Definition	Organization on behalf of which the contact is acting or for which the contact is working.
Cardinality	0...1
Type	Reference(Organization)
Requirements	For guardians or business related contacts, the organization is relevant.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
Patient.contact.period
Definition	The period during which this contact person or organization is valid to be contacted relating to this patient.
Cardinality	0...1
Type	Period
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: effectiveTime cda: n/a
Patient.communication
Definition	A language which may be used to communicate with the patient about his or her health.
Cardinality	0...1
Type	BackboneElement
Requirements	If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
Comments	If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: LanguageCommunication cda: patient.languageCommunication
Patient.communication.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.communication.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.communication.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Patient.communication.language
Definition	The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Cardinality	1...1
Type	CodeableConcept
Binding	A human language. CommonLanguages (preferred)
Requirements	Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Comments	The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
Patient.communication.preferred
Definition	Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Cardinality	0...1
Type	boolean
Requirements	People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.
Comments	This language is specifically identified for communicating healthcare information.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-15 rim: preferenceInd cda: .preferenceInd
Patient.generalPractitioner
Definition	Patient's nominated care provider.
Cardinality	0...1
Type	Reference(Organization \| Practitioner \| PractitionerRole)
Alias	careProvider
Comments	This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
Patient.managingOrganization
Definition	Organization that is the custodian of the patient record.
Cardinality	0...1
Type	Reference(Organization)
Summary	True
Requirements	Need to know who recognizes this patient record, manages and updates it.
Comments	There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: scoper cda: .providerOrganization
Patient.link
Definition	Link to another patient resource that concerns the same actual patient.
Cardinality	0...1
Type	BackboneElement
Modifier	True
Summary	True
Requirements	There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers.
Comments	There is no assumption that linked patient records have mutual links.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: outboundLink cda: n/a
Patient.link.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Patient.link.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.link.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
Patient.link.other
Definition	The other patient resource that the link refers to.
Cardinality	1...1
Type	Reference(Patient \| RelatedPerson)
Summary	True
Comments	Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PID-3, MRG-1 rim: id cda: n/a
Patient.link.other.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...0
Type	string
Mappings	rim: n/a
Patient.link.other.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Patient.link.other.reference
Definition	A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality	1...1
Type	string
Summary	True
Comments	See Mappings
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A resrouceType-PIRID: fullURL of Panorama + 'Patient' + <PIR Client ID>
Patient.link.other.type
Definition	The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality	0...1
Type	uri
Binding	Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)
Summary	True
Comments	This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A
Patient.link.other.identifier
Definition	An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality	0...1
Type	Identifier
Summary	True
Comments	When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .identifier
Patient.link.other.display
Definition	Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality	0...1
Type	string
Summary	True
Comments	This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A
Patient.link.type
Definition	Use 'replaces' for resourcePatient as the survivor patient out of a merge.
Cardinality	1...1
Type	code
Binding	The type of link between this patient resource and another patient resource. LinkType (required)
Summary	True
Comments	"replaces" non-survivor patient id with survivor patient id.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: typeCode cda: n/a

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="f68c0e19-c1e1-4a09-bb6a-9b071049522a" />
    <meta>
        <versionId value="10" />
        <lastUpdated value="2025-01-24T23:03:47.0556736+00:00" />
    </meta>
    <url value="http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient" />
    <name value="Patient_CAbaseline" />
    <status value="draft" />
    <date value="2022-02-18T18:22:50.968212Z" />
    <description value="Resource Patient is profiled based on Canadian Baseline" />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Patient" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
    <derivation value="constraint" />
    <differential>
        <element id="Patient">
            <path value="Patient" />
            <short value="IFHIR resource applies for PIR Client" />
            <definition value="IFHIR resource applies for PIR Client" />
        </element>
        <element id="Patient.id">
            <path value="Patient.id" />
            <short value="PIR Client ID" />
            <definition value="Unique Panorama Client ID" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="PIR subject_id" />
            </mapping>
        </element>
        <element id="Patient.meta">
            <path value="Patient.meta" />
            <min value="1" />
        </element>
        <element id="Patient.meta.versionId">
            <path value="Patient.meta.versionId" />
            <comment value="Apply &#39;2025.01.1&#39; (This indicates the FHIR Specs changes on 2025 - Jan)" />
        </element>
        <element id="Patient.meta.lastUpdated">
            <path value="Patient.meta.lastUpdated" />
            <comment value="Updated: Relax the previously crossed-out elements." />
        </element>
        <element id="Patient.meta.profile">
            <path value="Patient.meta.profile" />
            <comment value="Use &#39;http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient&#39;" />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Patient.meta.security">
            <path value="Patient.meta.security" />
            <max value="1" />
        </element>
        <element id="Patient.meta.tag">
            <path value="Patient.meta.tag" />
            <max value="1" />
        </element>
        <element id="Patient.contained">
            <path value="Patient.contained" />
            <max value="1" />
        </element>
        <element id="Patient.extension:genderIdentityExtension">
            <path value="Patient.extension" />
            <sliceName value="genderIdentityExtension" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-genderIdentity" />
            </type>
        </element>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <short value="Identifier(s) for this patient" />
            <definition value="Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN),  PI (Patient Internal Identifier e.g. PIR Client ID, HAs&#39; Internal Client ID)." />
            <comment value="Extract from PIR &lt;client.human_subject&gt;" />
            <min value="1" />
        </element>
        <element id="Patient.identifier.type">
            <path value="Patient.identifier.type" />
            <min value="1" />
        </element>
        <element id="Patient.identifier.type.coding">
            <path value="Patient.identifier.type.coding" />
            <min value="1" />
        </element>
        <element id="Patient.identifier.type.coding.system">
            <path value="Patient.identifier.type.coding.system" />
            <comment value="http://terminology.hl7.org/CodeSystem/v2-0203" />
            <fixedUri value="http://terminology.hl7.org/CodeSystem/v2-0203" />
        </element>
        <element id="Patient.identifier.type.coding.code">
            <path value="Patient.identifier.type.coding.code" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="JHN" />
                <map value="JHN" />
                <comment value="For all Canadian provincial health card number" />
            </mapping>
            <mapping>
                <identity value="JPID" />
                <map value="JPID" />
                <comment value="Jurisdictional Person Identification" />
            </mapping>
            <mapping>
                <identity value="MR" />
                <map value="MR" />
                <comment value="Medical Record Number" />
            </mapping>
            <mapping>
                <identity value="PI" />
                <map value="PI" />
                <comment value="Patient Internal Identifier" />
            </mapping>
        </element>
        <element id="Patient.identifier.type.text">
            <path value="Patient.identifier.type.text" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="Panorama Client ID" />
            </mapping>
            <mapping>
                <identity value="source-FHA" />
                <map value="FHA-PARIS Client ID" />
            </mapping>
            <mapping>
                <identity value="source-NHA-CeDaR" />
                <map value="NHA- CeDaR ID" />
            </mapping>
            <mapping>
                <identity value="source-NHA-MOIS" />
                <map value="NHA - MOIS ID" />
            </mapping>
            <mapping>
                <identity value="source-VCH" />
                <map value="VCH-PARIS Client ID" />
            </mapping>
            <mapping>
                <identity value="source-ProfileEMR" />
                <map value="ProfileEMR_ClientID" />
            </mapping>
            <mapping>
                <identity value="source-CAN-ArmedForces" />
                <map value="Canadian Armed Forces IDentification Number" />
            </mapping>
            <mapping>
                <identity value="source-CAN-RCMP" />
                <map value="Canadian RCMP Regiment Number" />
            </mapping>
            <mapping>
                <identity value="source-CAN-VeteranAffairs" />
                <map value="Veteran Affairs CAnadian Identification Number" />
            </mapping>
        </element>
        <element id="Patient.identifier.system">
            <path value="Patient.identifier.system" />
            <comment value="See Mappings below for appropriate URLs and URNs." />
            <min value="1" />
            <mapping>
                <identity value="JHN-BC" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id" />
                <comment value="British Columbia, Canada Personal Health Number" />
            </mapping>
            <mapping>
                <identity value="PI-PIR" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id" />
            </mapping>
            <mapping>
                <identity value="JHN-YT" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id" />
            </mapping>
            <mapping>
                <identity value="PI-FHA" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id" />
            </mapping>
            <mapping>
                <identity value="PI-NHA" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id" />
            </mapping>
            <mapping>
                <identity value="PI-VCH" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id" />
            </mapping>
            <mapping>
                <identity value="PI-CAN-ArmedForces" />
                <map value="urn: 2.16.840.1.113883.3.51.1.1.6.15" />
            </mapping>
            <mapping>
                <identity value="PI-RCMP" />
                <map value="urn:2.16.840.1.113883.3.51.1.1.6.16" />
            </mapping>
            <mapping>
                <identity value="PI-CAN-VeteranAffairs" />
                <map value="urn:2.16.840.1.113883.3.51.1.1.6.18" />
            </mapping>
            <mapping>
                <identity value="PI-ProfileEMR" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id" />
            </mapping>
        </element>
        <element id="Patient.identifier.value">
            <path value="Patient.identifier.value" />
            <comment value="PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number)" />
            <min value="1" />
            <mapping>
                <identity value="JHN-BC" />
                <map value="Extract from PIR (client.human_subject.health_card_number)" />
            </mapping>
            <mapping>
                <identity value="JHN-YT" />
                <map value="Extract from PIR (client.human_subject.health_card_number)" />
            </mapping>
            <mapping>
                <identity value="PI-PIR" />
                <map value="Extract from PIR (client.human_subject.subject_id)" />
            </mapping>
            <mapping>
                <identity value="PI-FHA" />
                <map value="FHA-PARIS Client ID" />
            </mapping>
            <mapping>
                <identity value="PI-NHA" />
                <map value="NHA- CeDaR ID" />
            </mapping>
            <mapping>
                <identity value="PI-VCH" />
                <map value="VCH-PARIS Client ID" />
            </mapping>
        </element>
        <element id="Patient.active">
            <path value="Patient.active" />
            <short value="Whether this patient&#39;s record is in active use in PIR." />
            <definition value="It is used to filter patient lists to exclude inactive patients   Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased)." />
            <comment value="Hardcode as &#39;True&#39; for all PIR active clients." />
            <min value="1" />
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <definition value="PIR Client Lastname, Firstname, Middlename" />
            <comment value="Extract from PIR &lt;client.human_subject&gt;" />
            <min value="1" />
        </element>
        <element id="Patient.name.use">
            <path value="Patient.name.use" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="legal" />
                <map value="official" />
            </mapping>
            <mapping>
                <identity value="alias" />
                <map value="usual" />
            </mapping>
        </element>
        <element id="Patient.name.family">
            <path value="Patient.name.family" />
            <short value="Patient Family Name" />
            <definition value="Patient Family Name" />
            <comment value="Patient Family Name" />
            <min value="1" />
        </element>
        <element id="Patient.name.given">
            <path value="Patient.name.given" />
            <short value="Patient Given Names" />
            <definition value="Patient Given Names" />
            <comment value="Patient Given Names" />
            <min value="1" />
        </element>
        <element id="Patient.name.prefix">
            <path value="Patient.name.prefix" />
            <max value="1" />
        </element>
        <element id="Patient.name.suffix">
            <path value="Patient.name.suffix" />
            <max value="1" />
        </element>
        <element id="Patient.telecom">
            <path value="Patient.telecom" />
            <short value="A contact detail for the PIR Client" />
            <definition value="A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted." />
        </element>
        <element id="Patient.telecom.id">
            <path value="Patient.telecom.id" />
            <max value="0" />
        </element>
        <element id="Patient.telecom.system">
            <path value="Patient.telecom.system" />
            <comment value="Use &#39;phone | email&#39;. Extract the current phone or email from PIR, not the ones with &#39;Effective Date To&#39; populated." />
        </element>
        <element id="Patient.telecom.value">
            <path value="Patient.telecom.value" />
            <short value="Patient Phone Number or Email" />
            <definition value="Patient Phone Number or Email" />
            <comment value="Patient Phone Number | Email" />
        </element>
        <element id="Patient.telecom.use">
            <path value="Patient.telecom.use" />
            <short value="home | work | mobile - purpose of this contact point" />
            <comment value="Use &quot;home&quot; | &quot;work&quot; |&quot;mobile&quot;  (See Mappings).  If not listed in the mappings, drop the attirubte USE, do not send." />
            <mapping>
                <identity value="pirHOME" />
                <map value="home" />
            </mapping>
            <mapping>
                <identity value="pirBUSINESS" />
                <map value="work" />
            </mapping>
            <mapping>
                <identity value="pirMOBILE" />
                <map value="mobile" />
            </mapping>
        </element>
        <element id="Patient.telecom.rank">
            <path value="Patient.telecom.rank" />
            <max value="0" />
        </element>
        <element id="Patient.telecom.period.id">
            <path value="Patient.telecom.period.id" />
            <max value="0" />
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <definition value="Patient Administrative Gender.  PIR gender &quot;Undifferentiate&quot; is mapped to &quot;unknown&quot; in FHIR." />
            <comment value="Patient Administrative Gender" />
            <min value="1" />
        </element>
        <element id="Patient.gender.id">
            <path value="Patient.gender.id" />
            <max value="0" />
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <short value="Patient Date of Birth" />
            <definition value="Patient Date of Birth" />
            <comment value="Patient Date of Birth (yyyy-mm-dd)" />
            <min value="1" />
        </element>
        <element id="Patient.address">
            <path value="Patient.address" />
            <comment value="Extract the LATEST client address from PIR" />
            <max value="1" />
        </element>
        <element id="Patient.address.use">
            <path value="Patient.address.use" />
            <definition value="The purpose of this address: home | work" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="pir-PrimaryHome" />
                <map value="home" />
            </mapping>
        </element>
        <element id="Patient.address.type">
            <path value="Patient.address.type" />
            <comment value="See Mappings." />
            <mapping>
                <identity value="pir-PostalAddress" />
                <map value="postal" />
            </mapping>
        </element>
        <element id="Patient.address.line">
            <path value="Patient.address.line" />
            <comment value="Use address.line for international address" />
        </element>
        <element id="Patient.address.line.extension:_line">
            <path value="Patient.address.line.extension" />
            <sliceName value="_line" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP" />
            </type>
        </element>
        <element id="Patient.photo">
            <path value="Patient.photo" />
            <max value="1" />
        </element>
        <element id="Patient.contact">
            <path value="Patient.contact" />
            <max value="1" />
        </element>
        <element id="Patient.communication">
            <path value="Patient.communication" />
            <max value="1" />
        </element>
        <element id="Patient.generalPractitioner">
            <path value="Patient.generalPractitioner" />
            <max value="1" />
        </element>
        <element id="Patient.link">
            <path value="Patient.link" />
            <max value="1" />
        </element>
        <element id="Patient.link.other.id">
            <path value="Patient.link.other.id" />
            <max value="0" />
        </element>
        <element id="Patient.link.other.reference">
            <path value="Patient.link.other.reference" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="resrouceType-PIRID" />
                <map value="fullURL of Panorama + &#39;Patient&#39; + &lt;PIR Client ID&gt;" />
            </mapping>
        </element>
        <element id="Patient.link.type">
            <path value="Patient.link.type" />
            <definition value="Use &#39;replaces&#39; for resourcePatient as the survivor patient out of a merge." />
            <comment value="&quot;replaces&quot; non-survivor patient id with survivor patient id." />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "f68c0e19-c1e1-4a09-bb6a-9b071049522a",
    "meta": {
        "versionId": "10",
        "lastUpdated": "01/24/2025 23:03:47"
    },
    "url": "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient",
    "name": "Patient_CAbaseline",
    "status": "draft",
    "date": "02/18/2022 18:22:50",
    "description": "Resource Patient is profiled based on Canadian Baseline",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient",
                "path": "Patient",
                "short": "IFHIR resource applies for PIR Client",
                "definition": "IFHIR resource applies for PIR Client"
            },
            {
                "id": "Patient.id",
                "path": "Patient.id",
                "short": "PIR Client ID",
                "definition": "Unique Panorama Client ID",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "PIR subject_id"
                    }
                ]
            },
            {
                "id": "Patient.meta",
                "path": "Patient.meta",
                "min": 1
            },
            {
                "id": "Patient.meta.versionId",
                "path": "Patient.meta.versionId",
                "comment": "Apply '2025.01.1' (This indicates the FHIR Specs changes on 2025 - Jan)"
            },
            {
                "id": "Patient.meta.lastUpdated",
                "path": "Patient.meta.lastUpdated",
                "comment": "Updated: Relax the previously crossed-out elements."
            },
            {
                "id": "Patient.meta.profile",
                "path": "Patient.meta.profile",
                "comment": "Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient'",
                "min": 1,
                "max": "1"
            },
            {
                "id": "Patient.meta.security",
                "path": "Patient.meta.security",
                "max": "1"
            },
            {
                "id": "Patient.meta.tag",
                "path": "Patient.meta.tag",
                "max": "1"
            },
            {
                "id": "Patient.contained",
                "path": "Patient.contained",
                "max": "1"
            },
            {
                "id": "Patient.extension:genderIdentityExtension",
                "path": "Patient.extension",
                "sliceName": "genderIdentityExtension",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-genderIdentity"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "short": "Identifier(s) for this patient",
                "definition": "Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN),  PI (Patient Internal Identifier e.g. PIR Client ID, HAs' Internal Client ID).",
                "comment": "Extract from PIR <client.human_subject>",
                "min": 1
            },
            {
                "id": "Patient.identifier.type",
                "path": "Patient.identifier.type",
                "min": 1
            },
            {
                "id": "Patient.identifier.type.coding",
                "path": "Patient.identifier.type.coding",
                "min": 1
            },
            {
                "id": "Patient.identifier.type.coding.system",
                "path": "Patient.identifier.type.coding.system",
                "comment": "http://terminology.hl7.org/CodeSystem/v2-0203",
                "fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0203"
            },
            {
                "id": "Patient.identifier.type.coding.code",
                "path": "Patient.identifier.type.coding.code",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "JHN",
                        "map": "JHN",
                        "comment": "For all Canadian provincial health card number"
                    },
                    {
                        "identity": "JPID",
                        "map": "JPID",
                        "comment": "Jurisdictional Person Identification"
                    },
                    {
                        "identity": "MR",
                        "map": "MR",
                        "comment": "Medical Record Number"
                    },
                    {
                        "identity": "PI",
                        "map": "PI",
                        "comment": "Patient Internal Identifier"
                    }
                ]
            },
            {
                "id": "Patient.identifier.type.text",
                "path": "Patient.identifier.type.text",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "Panorama Client ID"
                    },
                    {
                        "identity": "source-FHA",
                        "map": "FHA-PARIS Client ID"
                    },
                    {
                        "identity": "source-NHA-CeDaR",
                        "map": "NHA- CeDaR ID"
                    },
                    {
                        "identity": "source-NHA-MOIS",
                        "map": "NHA - MOIS ID"
                    },
                    {
                        "identity": "source-VCH",
                        "map": "VCH-PARIS Client ID"
                    },
                    {
                        "identity": "source-ProfileEMR",
                        "map": "ProfileEMR_ClientID"
                    },
                    {
                        "identity": "source-CAN-ArmedForces",
                        "map": "Canadian Armed Forces IDentification Number"
                    },
                    {
                        "identity": "source-CAN-RCMP",
                        "map": "Canadian RCMP Regiment Number"
                    },
                    {
                        "identity": "source-CAN-VeteranAffairs",
                        "map": "Veteran Affairs CAnadian Identification Number"
                    }
                ]
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "comment": "See Mappings below for appropriate URLs and URNs.",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "JHN-BC",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id",
                        "comment": "British Columbia, Canada Personal Health Number"
                    },
                    {
                        "identity": "PI-PIR",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id"
                    },
                    {
                        "identity": "JHN-YT",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id"
                    },
                    {
                        "identity": "PI-FHA",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id"
                    },
                    {
                        "identity": "PI-NHA",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id"
                    },
                    {
                        "identity": "PI-VCH",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id"
                    },
                    {
                        "identity": "PI-CAN-ArmedForces",
                        "map": "urn: 2.16.840.1.113883.3.51.1.1.6.15"
                    },
                    {
                        "identity": "PI-RCMP",
                        "map": "urn:2.16.840.1.113883.3.51.1.1.6.16"
                    },
                    {
                        "identity": "PI-CAN-VeteranAffairs",
                        "map": "urn:2.16.840.1.113883.3.51.1.1.6.18"
                    },
                    {
                        "identity": "PI-ProfileEMR",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id"
                    }
                ]
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "comment": "PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number)",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "JHN-BC",
                        "map": "Extract from PIR (client.human_subject.health_card_number)"
                    },
                    {
                        "identity": "JHN-YT",
                        "map": "Extract from PIR (client.human_subject.health_card_number)"
                    },
                    {
                        "identity": "PI-PIR",
                        "map": "Extract from PIR (client.human_subject.subject_id)"
                    },
                    {
                        "identity": "PI-FHA",
                        "map": "FHA-PARIS Client ID"
                    },
                    {
                        "identity": "PI-NHA",
                        "map": "NHA- CeDaR ID"
                    },
                    {
                        "identity": "PI-VCH",
                        "map": "VCH-PARIS Client ID"
                    }
                ]
            },
            {
                "id": "Patient.active",
                "path": "Patient.active",
                "short": "Whether this patient's record is in active use in PIR.",
                "definition": "It is used to filter patient lists to exclude inactive patients   Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased).",
                "comment": "Hardcode as 'True' for all PIR active clients.",
                "min": 1
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "definition": "PIR Client Lastname, Firstname, Middlename",
                "comment": "Extract from PIR <client.human_subject>",
                "min": 1
            },
            {
                "id": "Patient.name.use",
                "path": "Patient.name.use",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "legal",
                        "map": "official"
                    },
                    {
                        "identity": "alias",
                        "map": "usual"
                    }
                ]
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "short": "Patient Family Name",
                "definition": "Patient Family Name",
                "comment": "Patient Family Name",
                "min": 1
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "short": "Patient Given Names",
                "definition": "Patient Given Names",
                "comment": "Patient Given Names",
                "min": 1
            },
            {
                "id": "Patient.name.prefix",
                "path": "Patient.name.prefix",
                "max": "1"
            },
            {
                "id": "Patient.name.suffix",
                "path": "Patient.name.suffix",
                "max": "1"
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "short": "A contact detail for the PIR Client",
                "definition": "A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted."
            },
            {
                "id": "Patient.telecom.id",
                "path": "Patient.telecom.id",
                "max": "0"
            },
            {
                "id": "Patient.telecom.system",
                "path": "Patient.telecom.system",
                "comment": "Use 'phone | email'. Extract the current phone or email from PIR, not the ones with 'Effective Date To' populated."
            },
            {
                "id": "Patient.telecom.value",
                "path": "Patient.telecom.value",
                "short": "Patient Phone Number or Email",
                "definition": "Patient Phone Number or Email",
                "comment": "Patient Phone Number | Email"
            },
            {
                "id": "Patient.telecom.use",
                "path": "Patient.telecom.use",
                "short": "home | work | mobile - purpose of this contact point",
                "comment": "Use \"home\" | \"work\" |\"mobile\"  (See Mappings).  If not listed in the mappings, drop the attirubte USE, do not send.",
                "mapping":  [
                    {
                        "identity": "pirHOME",
                        "map": "home"
                    },
                    {
                        "identity": "pirBUSINESS",
                        "map": "work"
                    },
                    {
                        "identity": "pirMOBILE",
                        "map": "mobile"
                    }
                ]
            },
            {
                "id": "Patient.telecom.rank",
                "path": "Patient.telecom.rank",
                "max": "0"
            },
            {
                "id": "Patient.telecom.period.id",
                "path": "Patient.telecom.period.id",
                "max": "0"
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "definition": "Patient Administrative Gender.  PIR gender \"Undifferentiate\" is mapped to \"unknown\" in FHIR.",
                "comment": "Patient Administrative Gender",
                "min": 1
            },
            {
                "id": "Patient.gender.id",
                "path": "Patient.gender.id",
                "max": "0"
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "short": "Patient Date of Birth",
                "definition": "Patient Date of Birth",
                "comment": "Patient Date of Birth (yyyy-mm-dd)",
                "min": 1
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "comment": "Extract the LATEST client address from PIR",
                "max": "1"
            },
            {
                "id": "Patient.address.use",
                "path": "Patient.address.use",
                "definition": "The purpose of this address: home | work",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "pir-PrimaryHome",
                        "map": "home"
                    }
                ]
            },
            {
                "id": "Patient.address.type",
                "path": "Patient.address.type",
                "comment": "See Mappings.",
                "mapping":  [
                    {
                        "identity": "pir-PostalAddress",
                        "map": "postal"
                    }
                ]
            },
            {
                "id": "Patient.address.line",
                "path": "Patient.address.line",
                "comment": "Use address.line for international address"
            },
            {
                "id": "Patient.address.line.extension:_line",
                "path": "Patient.address.line.extension",
                "sliceName": "_line",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.photo",
                "path": "Patient.photo",
                "max": "1"
            },
            {
                "id": "Patient.contact",
                "path": "Patient.contact",
                "max": "1"
            },
            {
                "id": "Patient.communication",
                "path": "Patient.communication",
                "max": "1"
            },
            {
                "id": "Patient.generalPractitioner",
                "path": "Patient.generalPractitioner",
                "max": "1"
            },
            {
                "id": "Patient.link",
                "path": "Patient.link",
                "max": "1"
            },
            {
                "id": "Patient.link.other.id",
                "path": "Patient.link.other.id",
                "max": "0"
            },
            {
                "id": "Patient.link.other.reference",
                "path": "Patient.link.other.reference",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "resrouceType-PIRID",
                        "map": "fullURL of Panorama + 'Patient' + <PIR Client ID>"
                    }
                ]
            },
            {
                "id": "Patient.link.type",
                "path": "Patient.link.type",
                "definition": "Use 'replaces' for resourcePatient as the survivor patient out of a merge.",
                "comment": "\"replaces\" non-survivor patient id with survivor patient id."
            }
        ]
    }
}