Patient (CA-Core)

There are no (further) constraints on this element

Element id

Patient

Short description

Information about an individual or animal receiving health care services

Alternate names

SubjectOfCare Client Resident

Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Data type

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.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-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-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
rim: Patient[classCode=PAT]
cda: ClinicalDocument.recordTarget.patientRole

0..1

There are no (further) constraints on this element

Element id

Patient.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

MaxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

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: Entity. Role, or Act
rim: N/A

extension

0..*

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

indigenousIdentity

0..*

Element id

Patient.extension:indigenousIdentity

Short description

Extension for representing a code classifying a person's indigenous identity.

Alternate names

extensions, user content

Definition

A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.

Comments

Data type

Extension URL

IndigenousIdentity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
CACDI: Indigenous Identity

racializedGroup

0..*

Element id

Patient.extension:racializedGroup

Short description

Extension for representing a code classifying a person's racialized group.

Alternate names

extensions, user content

Definition

A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.

Comments

Data type

Extension URL

RacializedGroup

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

recordedSexOrGender

0..*

Extension(Complex)

Element id

Patient.extension:recordedSexOrGender

Short description

Recorded sex or gender (RSG) information includes the various sex and gender concepts.

Alternate names

extensions, user content

Definition

Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction.

Comments

Data type

Extension(Complex)

Extension URL

RecordedSexOrGender

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
CACDI: Gender Used

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.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

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

value

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value

Short description

The recorded sex or gender property for the individual

Alternate names

extensions, user content

Definition

A sex or gender property for the individual from a document or other record

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

RecordedGenderValueSet (preferred)

Fixed value

value

Mappings

rim: N/A

value[x]

1..1

Binding

Element id

Patient.extension:recordedSexOrGender.extension:value.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

type

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:type

Short description

Type of recorded sex or gender.

Alternate names

extensions, user content

Definition

The type or category of sex or gender that is recorded.

Comments

Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension: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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:type.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:type.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

RecordedSexOrGenderType (example)

Fixed value

type

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:type.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

effectivePeriod

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:effectivePeriod

Short description

When the recorded sex or gender value applies

Alternate names

extensions, user content

Definition

The time period during which the recorded sex or gender value applies to the individual

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:effectivePeriod.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:effectivePeriod.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

effectivePeriod

Mappings

rim: N/A

value[x]

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:effectivePeriod.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valuePeriod

There are no (further) constraints on this element

Data type

acquisitionDate

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:acquisitionDate

Short description

When the sex or gender value was recorded.

Alternate names

extensions, user content

Definition

The date/time when the sex or gender value was first recorded in the system.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:acquisitionDate.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:acquisitionDate.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

acquisitionDate

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:acquisitionDate.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueDateTime

There are no (further) constraints on this element

Data type

source

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:source

Short description

The source of the Recorded Sex or Gender value.

Alternate names

extensions, user content

Definition

A reference to the source of the Recorded Sex or Gender value.

Comments

Unlike the sourceDocument element, this element can reference non-document sources including applications, organisations or individuals. For example, if the Recored Sex or Gender value is recorded in a national patient identifier system this element may reference that system. This element can also be the source of the document referred to in the sourceDocument element. If values for sourceDocument and source are both present, then the sourceDocument may be assumed to have originated from the source e.g. a clinical document in an electronic health record system.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:source.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:source.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:source.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

source

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:source.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

valueReference

Reference(Device | Organization | Practitioner | RelatedPerson)

There are no (further) constraints on this element

Data type

Reference(Device | Organization | Practitioner | RelatedPerson)

sourceDocument

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceDocument

Short description

The document the sex or gender property was acquired from.

Alternate names

extensions, user content

Definition

The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded.

Comments

For example, if a driver's license is scanned, this property may reference that scanned document. If values for sourceDocument and source are both present, then the sourceDocument may be assumed to have originated from the source e.g. a clinical document in an electronic health record system.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceDocument.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceDocument.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceDocument.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

sourceDocument

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceDocument.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

Reference(DocumentReference)

valueReference

There are no (further) constraints on this element

Data type

Reference(DocumentReference)

sourceField

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceField

Short description

The name of the field within the source document where this sex or gender property is initially recorded.

Alternate names

extensions, user content

Definition

The name of the field within the source document where this sex or gender property is initially recorded.

Comments

For example, if a sex value is acquired from a driver's license, and the name of the field on that driver's license is 'SEX', then a code describing that field can be provided. If the semantics of the field are known, they may be described in the comment. For example, if the 'SEX' field on a license in a particular state or province is populated based on an individual's indication of what gender they consider themselves to be, but the field label is 'SEX' for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is 'SEX' can be provided.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceField.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceField.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceField.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

sourceField

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:sourceField.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueString

There are no (further) constraints on this element

Data type

jurisdiction

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:jurisdiction

Short description

Who issued the document where the sex or gender was aquired

Alternate names

extensions, user content

Definition

Jurisdiction responsible for the source and/or the sourceDocument where the recored sex or gender value was acquired.

Comments

For example, a individual's driver's license or passport would be issued by a specific state or country.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:jurisdiction.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:jurisdiction.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:jurisdiction.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

JurisdictionValueSet (extensible)

Fixed value

jurisdiction

Mappings

rim: N/A

value[x]

1..1

Binding

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:jurisdiction.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

comment

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:comment

Short description

Context or source information about the recorded sex or gender

Alternate names

extensions, user content

Definition

Further explanation about the context or source of the recorded sex or gender value

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:comment.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:comment.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:comment.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

comment

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:comment.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueString

There are no (further) constraints on this element

Data type

genderElementQualifier

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:genderElementQualifier

Short description

Whether this recorded sex or gender value qualifies the .gender element.

Alternate names

extensions, user content

Definition

Instances of the individual-recordedSexOrGender extension with this value set to 'true' provides additional semantics or provenance of the data communicated in the relevant '.gender' property in the resource. For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:genderElementQualifier.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

genderElementQualifier

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:genderElementQualifier.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueBoolean

There are no (further) constraints on this element

Data type

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender

Mappings

rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

genderIdentity

0..*

Extension(Complex)

Element id

Patient.extension:genderIdentity

Short description

Extension for representing how the person prefers to self-describe.

Alternate names

extensions, user content

Definition

A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings.

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Data type

Extension(Complex)

Extension URL

PGenderIdentity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
CACDI: Gender Identity

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

value

1..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value

Short description

The individual's gender identity

Alternate names

extensions, user content

Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

GenderIdentityValueSet (extensible)

Fixed value

value

Mappings

rim: N/A

value[x]

1..1

Binding

Element id

Patient.extension:genderIdentity.extension:value.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

There are no (further) constraints on this element

Data type

period

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:period

Short description

The time period during which the gender identity applies to the individual

Alternate names

extensions, user content

Definition

The time period during which the gender identity applies to the individual

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension: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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:period.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:period.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

period

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:period.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valuePeriod

There are no (further) constraints on this element

Data type

comment

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:comment

Short description

Text to further explain the use of the specified gender identity

Alternate names

extensions, user content

Definition

Text to further explain the use of the specified gender identity

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:comment.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

Mappings

rim: n/a

extension

0..0

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:comment.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:comment.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

comment

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:comment.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueString

There are no (further) constraints on this element

Data type

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

Fixed value

http://hl7.org/fhir/StructureDefinition/individual-genderIdentity

Mappings

rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

pronouns

0..*

Extension(Complex)

Element id

Patient.extension:pronouns

Short description

Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)

Alternate names

extensions, user content

Definition

A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression.

Comments

This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release

Data type

Extension(Complex)

Extension URL

Pronouns

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
CACDI: Personal Pronouns

birthsex

0..1

Element id

Patient.extension:birthsex

Short description

A code that specifies the sex of a person at birth which is a clinical finding

Alternate names

extensions, user content

Definition

A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics.

Comments

Data type

Extension URL

ExtensionBirthSex

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
CACDI: Sex at Birth

CommunicationBarrier

0..*

Element id

Patient.extension:CommunicationBarrier

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension URL

CommunicationBarrier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

?! C

0..*

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

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

identifier

O Σ

0..*

Element id

Patient.identifier

Short description

An identifier for this patient

Definition

An identifier for this patient.

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Data type

Slicing

Unordered, Open, by type(Pattern)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

(All Slices)

The requirements in this element apply to all slices

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

O Σ

0..1

CodeableConceptBinding

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

Identifier Type Codes (extensible)

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
Jurisdictional Health Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Medical Record Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Passport Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "PPN"
    }
  ]
}

National Unique Identifier (Placeholder Concept)

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "NH"
    }
  ]
}

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context
CACDI: Person Identifier Type
CACDI: Party Non-Health Identifier Type
CACDI: Patient Health Identifier Type

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

system

O Σ

0..1

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

Identifier.system is always case sensitive.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType
CACDI: Party Non-Health Identifier System
CACDI: Patient Health Identifier System

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

O Σ

0..1

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

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

rim: n/a
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
CACDI: Person Identifier Value
CACDI: Party Non-Health Identifier
CACDI: Patient Health Identifier

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

Σ C

0..1

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.

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

0..1

There are no (further) constraints on this element

Element id

Patient.identifier.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier.period.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

start

O Σ C

0..1

Element id

Patient.identifier.period.start

Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

This attribute is considered 'Recommended - No Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: DR.1
rim: ./low
CACDI: Party Non-Health Identifier Effective Date
CACDI: Patient Health Identifier Effective Date

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

end

O Σ C

0..1

Element id

Patient.identifier.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

This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. Implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: DR.2
rim: ./high
CACDI: Party Non-Health Identifier Expiry Date
CACDI: Patient Health Identifier Expiry Date

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

assigner

Σ C

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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
CACDI: Identifier Issuing Organization Code

JHN

O Σ

0..*

Element id

Patient.identifier:JHN

Short description

Jurisdictional Health Number

Definition

Patient and person health numbers used by all jurisdictions across Canada

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

versionCode

0..1

Element id

Patient.identifier:JHN.extension:versionCode

Short description

Health Number Version Code

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

ExtensionIdentifierVersion

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

SO Σ

1..1

CodeableConceptBindingPattern

Element id

Patient.identifier:JHN.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

Data type

Identifier Type Codes (extensible)

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Examples
Jurisdictional Health Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Medical Record Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Passport Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "PPN"
    }
  ]
}

National Unique Identifier (Placeholder Concept)

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "NH"
    }
  ]
}

Mappings

CACDI: Person Identifier Type
CACDI: Party Non-Health Identifier Type
CACDI: Patient Health Identifier Type
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.type.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

coding

0..*

CodingPattern

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

{
  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
  "code": "JHN"
}

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.type.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

system

0..1

uriPattern

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

http://terminology.hl7.org/CodeSystem/v2-0203

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

0..1

codePattern

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

JHN

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

Element id

Patient.identifier:JHN.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.

Comments

This V2 Code has a display value of "Jurisdictional Health Number". Display values are not fixed to prevent errors when using this profile to validate a resource instance in a multilingual context or where the display may be different from its source.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.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

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

system

SO Σ

1..1

Element id

Patient.identifier:JHN.system

Short description

A Health Number Naming System from the Canadian URI Registry

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

Identifier.system is always case sensitive.

Data type

https://simplifier.net/canadianuriregistry (example)

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

CACDI: Party Non-Health Identifier System
CACDI: Patient Health Identifier System
rim: II.root or Role.id.root
servd: ./IdentifierType

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

SO Σ

1..1

Element id

Patient.identifier:JHN.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

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

CACDI: Person Identifier Value
CACDI: Party Non-Health Identifier
CACDI: Patient Health Identifier
servd: ./Value

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

Σ C

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Element id

Patient.identifier:JHN.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

CACDI: Identifier Issuing Organization Code
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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

MRN

O Σ

0..*

Element id

Patient.identifier:MRN

Short description

Medical Record Number

Definition

A local patient identifier from the submitting PoS System

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Comments

Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

SO Σ

1..1

CodeableConceptBindingPattern

Element id

Patient.identifier:MRN.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

Data type

Identifier Type Codes (extensible)

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Examples
Jurisdictional Health Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Medical Record Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Passport Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "PPN"
    }
  ]
}

National Unique Identifier (Placeholder Concept)

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "NH"
    }
  ]
}

Mappings

CACDI: Person Identifier Type
CACDI: Party Non-Health Identifier Type
CACDI: Patient Health Identifier Type
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.type.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

coding

0..*

CodingPattern

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Data type

Coding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

{
  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
  "code": "MR"
}

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.type.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

system

0..1

uriPattern

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

http://terminology.hl7.org/CodeSystem/v2-0203

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.type.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

0..1

codePattern

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

MR

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

Element id

Patient.identifier:MRN.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.

Comments

This V2 Code has a display value of "Medical Record Number". Display values are not fixed to prevent errors when using this profile to validate a resource instance in a multilingual context or where the display may be different from its source.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.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

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

system

SO Σ

1..1

Element id

Patient.identifier:MRN.system

Short description

An identifier for the system supplying the MRN

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

Identifier.system is always case sensitive.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

CACDI: Party Non-Health Identifier System
CACDI: Patient Health Identifier System
rim: II.root or Role.id.root
servd: ./IdentifierType

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

SO Σ

1..1

Element id

Patient.identifier:MRN.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

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

CACDI: Person Identifier Value
CACDI: Party Non-Health Identifier
CACDI: Patient Health Identifier
servd: ./Value

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

Σ C

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Element id

Patient.identifier:MRN.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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

CACDI: Identifier Issuing Organization Code
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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 ?!

0..1

Element id

Patient.active

Short description

Whether this patient's record is in active use

Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients

Meaning when missing

This resource is generally assumed to be active if no value is provided for the active element

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
w5: FiveWs.status
rim: statusCode
cda: n/a

name

O Σ C

0..*

Element id

Patient.name

Short description

A name associated with the patient

Definition

A name associated with the individual.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present.
(family.exists() or given.exists())

Mappings

rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: PID-5, PID-9
rim: name
cda: .patient.name

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

use

Σ ?!

0..1

codeBinding

Element id

Patient.name.use

Short description

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

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Data type

Binding

The use of a human name.

NameUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN.7, but often indicated by which field contains the name
rim: unique(./use)
servd: ./NamePurpose
CACDI: Name Used
CACDI: Name Type

text

0..1

Element id

Patient.name.text

Short description

Text representation of the full name

Definition

Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element

Requirements

A renderable, unencoded form.

Comments

Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: implied by XPN.11
rim: ./formatted

family

O Σ

0..1

Element id

Patient.name.family

Short description

Family name (often called 'Surname')

Alternate names

surname

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN.1/FN.1
rim: ./part[partType = FAM]
servd: ./FamilyName
CACDI: Surname

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

given

O Σ

0..*

Element id

Patient.name.given

Short description

Given names (not always 'first'). Includes middle names

Alternate names

first name, middle name

Definition

Given name.

Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN.2 + XPN.3
rim: ./part[partType = GIV]
servd: ./GivenNames
CACDI: Given Name
CACDI: Middle Name

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

prefix

0..*

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN.5
rim: ./part[partType = PFX]
servd: ./TitleCode

suffix

0..*

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN/4
rim: ./part[partType = SFX]

period

Σ C

0..1

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: XPN.13 + XPN.14
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate

0..1

There are no (further) constraints on this element

Element id

Patient.name.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Patient.name.period.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

start

Σ C

0..1

Element id

Patient.name.period.start

Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: DR.1
rim: ./low

end

Σ C

0..1

Element id

Patient.name.period.end

Short description

End time with inclusive boundary, if not ongoing

Definition

Comments

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: DR.2
rim: ./high

telecom

O Σ C

0..*

Element id

Patient.telecom

Short description

A contact detail for the individual

Definition

A contact detail (e.g. a telephone number or an email address) by which the individual 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()

Mappings

rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

system

O Σ C

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

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Binding

Telecommunications form for contact point.

ContactPointSystem (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, cpt-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XTN.3
rim: ./scheme
servd: ./ContactPointType

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

O Σ

0..1

Element id

Patient.telecom.value

Short description

The actual contact point details

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XTN.1 (or XTN.12)
rim: ./url
servd: ./Value

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

use

O Σ ?!

0..1

codeBinding

Element id

Patient.telecom.use

Short description

home | work | temp | old | 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

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Data type

Binding

Use of contact point.

ContactPointUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XTN.2 - but often indicated by field
rim: unique(./use)
servd: ./ContactPointPurpose

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

rank

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: n/a

period

Σ C

0..1

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: N/A
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate

gender

O Σ

0..1

codeBinding

Element id

Patient.gender

Short description

The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.

Definition

Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Data type

AdministrativeGender (required)

Binding

The gender of a person used for administrative purposes.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: PID-8
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
cda: .patient.administrativeGenderCode

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

birthDate

O Σ

0..1

date

Element id

Patient.birthDate

Short description

The date of birth for the individual

Definition

The date of birth for the individual.

Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

Data type

date

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: PID-7
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
cda: .patient.birthTime
loinc: 21112-8
CACDI: Date of Birth

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

There are no (further) constraints on this element

Element id

Patient.birthDate.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

Mappings

rim: n/a

extension

0..*

Element id

Patient.birthDate.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

birthTime

0..1

Element id

Patient.birthDate.extension:birthTime

Short description

Time of day of birth

Alternate names

extensions, user content

Definition

The time of day that the Patient/Person/RelatedPerson/Practitioner was born. This includes the date to ensure that the timezone information can be communicated effectively.

Comments

The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)

Data type

Extension URL

PatBirthTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

value

0..1

System.Date

There are no (further) constraints on this element

Element id

Patient.birthDate.value

Short description

Primitive value for date

Definition

Primitive value for date

Data type

System.Date

deceased[x]

O Σ ?!

0..1

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.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

deceasedBoolean

There are no (further) constraints on this element

Data type

deceasedDateTime

Σ ?!

0..1

Element id

Patient.deceased[x]:deceasedDateTime

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

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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
CACDI: Date of Death

address

O Σ

0..*

Element id

Patient.address

Short description

An address expressed using postal conventions (as opposed to GPS or other location definition formats)

Definition

An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Comments

Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XAD
rim: AD
servd: Address
v2: PID-11
rim: addr
cda: .addr

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.address.use

Short description

home | work | temp | old | billing - purpose of this address

Definition

The purpose of this address.

Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Data type

Binding

The use of an address.

AddressUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

home

Mappings

rim: n/a
v2: XAD.7
rim: unique(./use)
servd: ./AddressPurpose

type

0..1

codeBinding

There are no (further) constraints on this element

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

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Data type

Binding

The type of an address (physical / postal).

AddressType (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

both

Mappings

rim: n/a
v2: XAD.18
rim: unique(./use)
vcard: address type parameter

text

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

rim: n/a
v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
rim: ./formatted
vcard: address label parameter

line

O Σ

0..*

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

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

137 Nowhere Street

Mappings

rim: n/a
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)

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

city

0..1

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Erewhon

Mappings

rim: n/a
v2: XAD.3
rim: AD.part[parttype = CTY]
vcard: locality
servd: ./Jurisdiction

district

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Madison

Mappings

rim: n/a
v2: XAD.9
rim: AD.part[parttype = CNT | CPA]

state

0..1

There are no (further) constraints on this element

Element id

Patient.address.state

Short description

The Province or Territory of Canada, or Province, Territory of State of another country

Alternate names

Province, Territory

Definition

The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XAD.4
rim: AD.part[parttype = STA]
vcard: region
servd: ./Region

postalCode

O Σ

0..1

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: XAD.5
rim: AD.part[parttype = ZIP]
vcard: code
servd: ./PostalIdentificationCode

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

country

O Σ

0..1

Element id

Patient.address.country

Short description

Recommend use of the HL7 Country ValueSet 3 letter code

Definition

Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html

Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XAD.6
rim: AD.part[parttype = CNT]
vcard: country
servd: ./Country

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

Σ C

0..1

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Examples
General

{
  "start": "2010-03-23",
  "end": "2010-07-01"
}

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
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.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

Marital Status Codes (extensible)

Binding

The domestic partnership status of a person.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
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).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
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

There are no (further) constraints on this element

Data type

multipleBirthInteger

integer

There are no (further) constraints on this element

Data type

integer

photo

0..*

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
att-1: If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()

Mappings

rim: n/a
v2: ED/RP
rim: ED
v2: OBX-5 - needs a profile
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
cda: n/a

contact

0..*

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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: n/a
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
cda: n/a

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Σ ?! C

0..*

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

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

relationship

0..*

CodeableConceptBinding

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.

Comments

The canonical URL for this binding may be updated in the future to facilitate French Display translations from the Canada Health Infoway Terminology Server.

Data type

PatientRelationshipType (extensible)

Binding

The nature of the relationship between a patient and a contact person for that patient.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: NK1-7, NK1-3
rim: code
cda: n/a

name

0..1

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.

Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: NK1-2
rim: name
cda: n/a

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

telecom

O C

0..*

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()

Mappings

rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

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.

Comments

Data type

Address

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: XAD
rim: AD
servd: Address
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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

AdministrativeGender (required)

Binding

The gender of a person used for administrative purposes.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: NK1-15
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
cda: n/a

organization

0..1

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.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, pat-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
rim: scoper
cda: n/a

period

0..1

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
rim: effectiveTime
cda: n/a

communication

0..*

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

where applicable, SHOULD be used to identify the preferred communication language for the patient

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: LanguageCommunication
cda: patient.languageCommunication

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Σ ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

language

1..1

CodeableConceptBinding

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

Binding

A human language.

CommonLanguages (preferred)

Additional bindings

ISO6393 (candidate)
ISO 639-3 Language Codes

Binding extensions

MaxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PID-15, LAN-2
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
cda: .languageCode
CACDI: Service Language
CACDI: Party Role Service Language

preferred

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: PID-15
rim: preferenceInd
cda: .preferenceInd

generalPractitioner

0..*

Reference(OrganizationCACore | PractitionerCACore | PractitionerRoleCACore)

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(OrganizationCACore | PractitionerCACore | PractitionerRoleCACore)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PD1-4
rim: subjectOf.CareEvent.performer.AssignedEntity
cda: n/a

managingOrganization

Σ C

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: scoper
cda: .providerOrganization

link

Σ ?!

0..*

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: outboundLink
cda: n/a

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Σ ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

other

Σ C

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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PID-3, MRG-1
rim: id
cda: n/a

type

1..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.link.type

Short description

replaced-by | replaces | refer | seealso

Definition

The type of link between this patient resource and another patient resource.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

Binding

The type of link between this patient resource and another patient resource.

LinkType (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: typeCode
cda: n/a

PatientCACore (Patient)

There are no (further) constraints on this element

Data type

extension

There are no (further) constraints on this element

Element id

Patient.extension

Slicing

Unordered, Open, by url(Value)

indigenousIdentity

0..*

There are no (further) constraints on this element

Element id

Patient.extension:indigenousIdentity

Short description

Extension for representing a code classifying a person's indigenous identity.

Definition

A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.

Data type

Extension URL

IndigenousIdentity

Mappings

CACDI: Indigenous Identity

racializedGroup

0..*

There are no (further) constraints on this element

Element id

Patient.extension:racializedGroup

Short description

Extension for representing a code classifying a person's racialized group.

Definition

A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.

Data type

RecordedGenderValueSet (preferred)

Extension URL

RacializedGroup

recordedSexOrGender

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender

Short description

Recorded sex or gender (RSG) information includes the various sex and gender concepts.

Definition

Data type

Extension(Complex)

Extension URL

RecordedSexOrGender

Mappings

CACDI: Gender Used

value

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value

value[x]

Binding

There are no (further) constraints on this element

Element id

Patient.extension:recordedSexOrGender.extension:value.value[x]

Binding

genderIdentity

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity

Short description

Extension for representing how the person prefers to self-describe.

Definition

Data type

Extension(Complex)

Extension URL

PGenderIdentity

Mappings

CACDI: Gender Identity

value

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value

value[x]

Binding

There are no (further) constraints on this element

Element id

Patient.extension:genderIdentity.extension:value.value[x]

Binding

GenderIdentityValueSet (extensible)

pronouns

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Patient.extension:pronouns

Short description

Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)

Definition

Data type

Extension(Complex)

Extension URL

Pronouns

Mappings

CACDI: Personal Pronouns

birthsex

0..1

There are no (further) constraints on this element

Element id

Patient.extension:birthsex

Short description

A code that specifies the sex of a person at birth which is a clinical finding

Definition

Data type

Extension URL

ExtensionBirthSex

Mappings

CACDI: Sex at Birth

CommunicationBarrier

0..*

There are no (further) constraints on this element

Element id

Patient.extension:CommunicationBarrier

Data type

Extension URL

CommunicationBarrier

identifier

There are no (further) constraints on this element

Element id

Patient.identifier

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Slicing

Unordered, Open, by type(Pattern)

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

(All Slices)

The requirements in this element apply to all slices

type

There are no (further) constraints on this element

Element id

Patient.identifier.type

Examples
Jurisdictional Health Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Medical Record Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Passport Number

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "PPN"
    }
  ]
}

National Unique Identifier (Placeholder Concept)

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "NH"
    }
  ]
}

Mappings

CACDI: Person Identifier Type
CACDI: Party Non-Health Identifier Type
CACDI: Patient Health Identifier Type

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

system

There are no (further) constraints on this element

Element id

Patient.identifier.system

Mappings

CACDI: Party Non-Health Identifier System
CACDI: Patient Health Identifier System

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

There are no (further) constraints on this element

Element id

Patient.identifier.value

Mappings

CACDI: Person Identifier Value
CACDI: Party Non-Health Identifier
CACDI: Patient Health Identifier

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

There are no (further) constraints on this element

start

There are no (further) constraints on this element

Element id

Patient.identifier.period.start

Comments

Mappings

CACDI: Party Non-Health Identifier Effective Date
CACDI: Patient Health Identifier Effective Date

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

end

There are no (further) constraints on this element

Element id

Patient.identifier.period.end

Comments

Mappings

CACDI: Party Non-Health Identifier Expiry Date
CACDI: Patient Health Identifier Expiry Date

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

assigner

There are no (further) constraints on this element

Element id

Patient.identifier.assigner

Mappings

CACDI: Identifier Issuing Organization Code

JHN

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:JHN

Short description

Jurisdictional Health Number

Definition

Patient and person health numbers used by all jurisdictions across Canada

versionCode

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.extension:versionCode

Short description

Health Number Version Code

Data type

ExtensionIdentifierVersion

Extension URL

type

1..

Pattern

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.type

Pattern

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

coding

Pattern

There are no (further) constraints on this element

Pattern

{
  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
  "code": "JHN"
}

display

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.type.coding.display

Comments

system

1..

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.system

Short description

A Health Number Naming System from the Canadian URI Registry

Binding

https://simplifier.net/canadianuriregistry (example)

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

1..

There are no (further) constraints on this element

Element id

Patient.identifier:JHN.value

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

MRN

0..*

There are no (further) constraints on this element

Element id

Patient.identifier:MRN

Short description

Medical Record Number

Definition

A local patient identifier from the submitting PoS System

Comments

type

1..

Pattern

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.type

Pattern

{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

coding

Pattern

There are no (further) constraints on this element

Pattern

{
  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
  "code": "MR"
}

display

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.type.coding.display

Comments

system

1..

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.system

Short description

An identifier for the system supplying the MRN

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

1..

There are no (further) constraints on this element

Element id

Patient.identifier:MRN.value

Obligations

Code	Actor
SHALL:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

active

There are no (further) constraints on this element

Element id

Patient.active

Comments

name

O C

There are no (further) constraints on this element

Element id

Patient.name

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Constraints

ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present.
(family.exists() or given.exists())

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

use

There are no (further) constraints on this element

Element id

Patient.name.use

Mappings

CACDI: Name Used
CACDI: Name Type

text

There are no (further) constraints on this element

Element id

Patient.name.text

Definition

Comments

family

There are no (further) constraints on this element

Element id

Patient.name.family

Mappings

CACDI: Surname

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

given

There are no (further) constraints on this element

Element id

Patient.name.given

Mappings

CACDI: Given Name
CACDI: Middle Name

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

period

There are no (further) constraints on this element

start

There are no (further) constraints on this element

Element id

Patient.name.period.start

Comments

end

There are no (further) constraints on this element

Element id

Patient.name.period.end

Comments

telecom

There are no (further) constraints on this element

Element id

Patient.telecom

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

system

There are no (further) constraints on this element

Element id

Patient.telecom.system

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

value

There are no (further) constraints on this element

Element id

Patient.telecom.value

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

use

There are no (further) constraints on this element

Element id

Patient.telecom.use

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

gender

There are no (further) constraints on this element

Element id

Patient.gender

Short description

Definition

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

birthDate

There are no (further) constraints on this element

Element id

Patient.birthDate

Mappings

CACDI: Date of Birth

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

extension

There are no (further) constraints on this element

Element id

Patient.birthDate.extension

Slicing

Unordered, Open, by url(Value)

birthTime

0..1

There are no (further) constraints on this element

Element id

Patient.birthDate.extension:birthTime

Data type

Extension URL

PatBirthTime

deceased[x]

There are no (further) constraints on this element

Element id

Patient.deceased[x]

Slicing

Unordered, Open, by $this(Type)

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

deceasedDateTime

0..1

There are no (further) constraints on this element

Element id

Patient.deceased[x]:deceasedDateTime

Data type

Mappings

CACDI: Date of Death

address

There are no (further) constraints on this element

Element id

Patient.address

Data type

PatientRelationshipType (extensible)

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

line

There are no (further) constraints on this element

Element id

Patient.address.line

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

postalCode

There are no (further) constraints on this element

Element id

Patient.address.postalCode

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

country

There are no (further) constraints on this element

Element id

Patient.address.country

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

contact

There are no (further) constraints on this element

relationship

Binding

There are no (further) constraints on this element

Element id

Patient.contact.relationship

Comments

The canonical URL for this binding may be updated in the future to facilitate French Display translations from the Canada Health Infoway Terminology Server.

Binding

name

There are no (further) constraints on this element

Element id

Patient.contact.name

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

telecom

There are no (further) constraints on this element

Element id

Patient.contact.telecom

Obligations

Code	Actor
MAY:populate-if-known	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-error	http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer

communication

There are no (further) constraints on this element

Element id

Patient.communication

Comments

where applicable, SHOULD be used to identify the preferred communication language for the patient

language

Binding

There are no (further) constraints on this element

Element id

Patient.communication.language

Binding

CommonLanguages (preferred)

Additional bindings

ISO6393 (candidate)
ISO 639-3 Language Codes

Mappings

CACDI: Service Language
CACDI: Party Role Service Language

generalPractitioner

Reference(OrganizationCACore | PractitionerCACore | PractitionerRoleCACore)

There are no (further) constraints on this element

Element id

Patient.generalPractitioner

Data type

Reference(OrganizationCACore | PractitionerCACore | PractitionerRoleCACore)

managingOrganization

There are no (further) constraints on this element

Element id

Patient.managingOrganization

Data type