DBIR Implementation Guide

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

Meta

Constraints

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

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

Constraints

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

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

Binding

A human language.

CommonLanguages (preferred)

Constraints

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

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Patient.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints

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

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Patient.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings

rim: N/A

extension

0..*

There are no (further) constraints on this element

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

http://hl7.org/fhir/StructureDefinition/patient-nationality

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

nationality

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Patient.extension:nationality

Short description

Nationality

Alternate names

extensions, user content

Definition

The nationality of the patient.

Comments

Due to the nature of the nationality core extension (which allows for a period to be placed next to the nationality and thus allows for different nationalities over time), the cardinality of the extension is left at 0..* instead of the zib cardinality of 0..1.

Data type

Extension(Complex)

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

0..1

There are no (further) constraints on this element

Element id

Patient.extension:nationality.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:nationality.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

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

code

0..1

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code

Short description

Nationality Code

Definition

Code representing nationality of patient.

Data type

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()

0..1

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.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:nationality.extension:code.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.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

NationaliteitCodelijst (extensible)

Fixed value

code

Mappings

rim: N/A

value[x]

1..1

Binding

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.value[x]

Short description

Nationality

Alternate names

Nationaliteit

Definition

Indicates the country of citizenship.

Binding

Constraints

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

Mappings

rim: N/A
zib-nationality-v3.0-2020EN: NL-CM:7.6.3

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:nationality.extension:period

Short description

Nationality Period

Definition

Period when nationality was effective.

Data type

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()

0..1

There are no (further) constraints on this element

Element id

Patient.extension:nationality.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:nationality.extension:period.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:nationality.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:nationality.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).

Constraints

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

Mappings

rim: N/A

valuePeriod

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:nationality.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/patient-nationality

Mappings

rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

Patient.extension:nationality.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).

Constraints

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

Mappings

rim: N/A

modifierExtension

?! I

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

identifier

0..*

There are no (further) constraints on this element

Element id

Patient.identifier

Short description

PatientIdentificationNumber

Alternate names

Identificatienummer

Definition

The patient’s identification number. In transfer situations, use of the social security number (BSN) must comply with the Use of Social Security Numbers in Healthcare Act (Wbsn-z). In other situations, other number systems can be used, such as internal hospital patient numbers for example.

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Sliced:

Unordered, Open, by $this(Value)

Constraints

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

Mappings

w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id
zib-patient-v3.2-2020EN: NL-CM:0.1.7

bsn

0..*

IdentifierPattern

There are no (further) constraints on this element

Element id

Patient.identifier:bsn

Short description

An identifier for this patient

Definition

An identifier for this patient.

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Constraints

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

Pattern

{
  "system": "http://fhir.nl/fhir/NamingSystem/bsn"
}

Mappings

w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id

SocialSecurityNumberCountry

1..1

IdentifierPattern

Element id

Patient.identifier:SocialSecurityNumberCountry

Short description

Country where social security number was issued

Alternate names

Identificatienummer

Definition

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Constraints

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

Pattern

{
  "system": "http://mrdm.nl/identifier/countryidcode"
}

Mappings

w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id
zib-patient-v3.2-2020EN: NL-CM:0.1.7

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.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:SocialSecurityNumberCountry.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.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)

Constraints

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

Mappings

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

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.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.

Constraints

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

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

uriPattern

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.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

Constraints

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

Pattern

http://mrdm.nl/identifier/countryidcode

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

stringBinding

Element id

Patient.identifier:SocialSecurityNumberCountry.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

http://mrdm.nl/identifier/countryidcode (preferred)

Binding

Constraints

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

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.period

Short description

Time period when id is/was valid for use

Definition

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

Data type

Constraints

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

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

Patient.identifier:SocialSecurityNumberCountry.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

Constraints

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

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

UPN

1..1

IdentifierPattern

Element id

Patient.identifier:UPN

Short description

Unique Patient Number

Alternate names

Identificatienummer

Definition

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Constraints

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

Pattern

{
  "system": "http://mrdm.nl/identifier/upn"
}

Mappings

w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id
zib-patient-v3.2-2020EN: NL-CM:0.1.7

active

Σ ?!

0..1

There are no (further) constraints on this element

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

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Meaning when missing

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

Data type

Constraints

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

Mappings

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

name

0..1

HumanName

There are no (further) constraints on this element

Element id

Patient.name

Short description

NameInformation / PayerName

Alternate names

Naamgegevens, BetalerNaam

Definition

Patient's full name.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

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

HumanName

Sliced:

Unordered, Open, by use(Value)

Constraints

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

Mappings

v2: PID-5, PID-9
rim: name
cda: .patient.name
zib-patient-v3.2-2020EN: NL-CM:0.1.6
zib-payer-v3.1.1-2020EN: NL-CM:1.1.5

nameInformation

Σ I

0..1

There are no (further) constraints on this element

Element id

Patient.name:nameInformation

Short description

NameInformation

Alternate names

Naamgegevens

Definition

This slice represents the person's official name information, including given names, last name and possibly the partner's last name.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

Comments

This .name element represents a Dutch name according to the zib NameInformation v1.1 (2020) (except for the GivenName concept).

Note 1: The zib cannot be represented straightforward in FHIR. Especially note the guidance on .given on how to map the FirstNames and Initials concepts, and on .prefix/.suffix on how to map the Titles concept.

Note 2: This element should only contain a person's official names. The GivenName concept is represented in another .name element with .name.use = usual.

Data type

ZibNameInformationGivenName

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
zib-NameInformation-1: If a prefix for a family name is specified, the family name is expected as well
family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()
zib-NameInformation-2: If the prefix for a partner family name is specified, the partner family name is expected as well
family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()

Mappings

v2: PID-5, PID-9
rim: name
cda: .patient.name
rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
zib-nameinformation-v1.1-2020EN: NL-CM:20.4.1

nameInformation-GivenName

0..1

There are no (further) constraints on this element

Element id

Patient.name:nameInformation-GivenName

Short description

Name of a human - parts and usage

Definition

This slice represents the name information normally used to address the person.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

Comments

This .name element represents the Dutch given name ("roepnaam") according to the zib NameInformation v1.1 (2020).

Note 1: This element should only contain a person's unofficial name. The official names are represented in one or more other .name elements with .name.use = official.

Note 2: The examples illustrate how the zib is mapped to FHIR.

Data type

ZibNameInformationGivenName

Constraints

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

Mappings

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

telecom

0..*

There are no (further) constraints on this element

Element id

Patient.telecom

Short description

ContactInformation

Alternate names

Contactgegevens

Definition

Patient’s telephone number(s) or e-mail address(es).

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

The cardinality mismatch between the zib (0..1) and FHIR (0..*) is explained by the containers TelephoneNumbers (0..*) and EmailAddresses (0..*) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.

Data type

Sliced:

Unordered, Open, by $this(Profile)

Constraints

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

Mappings

v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
zib-patient-v3.2-2020EN: NL-CM:0.1.5
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.1
zib-payer-v3.1.1-2020EN: NL-CM:1.1.12

telephoneNumbers

Σ I

0..*

There are no (further) constraints on this element

Element id

Patient.telecom:telephoneNumbers

Short description

TelephoneNumbers

Alternate names

Telefoonnummers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

Please note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts ContactPoint.system and ContactPoint.use respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on ContactPoint.system is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.

Data type

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

v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.2

emailAddresses

Σ I

0..*

There are no (further) constraints on this element

Element id

Patient.telecom:emailAddresses

Short description

EmailAddresses

Alternate names

EmailAdressen

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

Data type

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

v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.3

gender

1..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.gender

Short description

Gender

Alternate names

Geslacht

Definition

Patient’s administrative gender.

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

Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender.

Permitted Values

GeslachtCodelijst_to_AdministrativeGender

Constraints

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

Mappings

v2: PID-8
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
cda: .patient.administrativeGenderCode
zib-patient-v3.2-2020EN: NL-CM:0.1.9

0..1

There are no (further) constraints on this element

Element id

Patient.gender.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references)

Data type

extension

0..*

There are no (further) constraints on this element

Element id

Patient.gender.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

genderCodelist

0..1

There are no (further) constraints on this element

Element id

Patient.gender.extension:genderCodelist

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

There are no (further) constraints on this element

Element id

Patient.gender.extension:genderCodelist.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.gender.extension:genderCodelist.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.gender.extension:genderCodelist.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://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

Mappings

rim: N/A

value[x]

0..1

Binding

There are no (further) constraints on this element

Element id

Patient.gender.extension:genderCodelist.value[x]

Short description

Gender

Alternate names

Geslacht

Definition

Patient’s administrative gender.

Binding

GeslachtCodelijst

GeslachtCodelijst (required)

Constraints

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

Mappings

rim: N/A
zib-patient-v3.2-2020EN: NL-CM:0.1.9

valueCodeableConcept

There are no (further) constraints on this element

Data type

value

0..1

System.String

There are no (further) constraints on this element

Element id

Patient.gender.value

Short description

Primitive value for code

Definition

Primitive value for code

Data type

System.String

birthDate

1..1

date

There are no (further) constraints on this element

Element id

Patient.birthDate

Short description

DateOfBirth

Alternate names

Geboortedatum

Definition

Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted.

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

Constraints

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

Mappings

v2: PID-7
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
cda: .patient.birthTime
loinc: 21112-8
zib-patient-v3.2-2020EN: NL-CM:0.1.10

deceased[x]

Σ ?!

0..1

There are no (further) constraints on this element

Element id

Patient.deceased[x]

Short description

Indicates if the individual is deceased or not

Definition

Indicates if the individual is deceased or not.

Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Sliced:

Unordered, Open, by $this(Type)

Constraints

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

Mappings

v2: PID-30 (bool) and PID-29 (datetime)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
cda: n/a

deceasedBoolean

Σ ?!

0..1

There are no (further) constraints on this element

Element id

Patient.deceased[x]:deceasedBoolean

Short description

DeathIndicator

Alternate names

OverlijdensIndicator

Definition

An indication stating whether the patient has died.

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

Constraints

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

Mappings

v2: PID-30 (bool) and PID-29 (datetime)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
cda: n/a
zib-patient-v3.2-2020EN: NL-CM:0.1.32

deceasedDateTime

Σ ?!

0..1

dateTime

There are no (further) constraints on this element

Element id

Patient.deceased[x]:deceasedDateTime

Short description

DateOfDeath

Alternate names

DatumOverlijden, OverlijdensIndicator

Definition

The date on which the patient died. A ‘vague’ date, such as only the year, is permitted.

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

The zib recognizes both the DeathIndicator (boolean) and DateOfDeath (datetime) concepts, whereas in FHIR only one of these concepts may be present. Therefore, if deceasedDateTime is present and has a value, its value can be mapped to DateOfDeath and DeathIndicator is assumed to be true.

Data type

dateTime

Constraints

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

Mappings

v2: PID-30 (bool) and PID-29 (datetime)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
cda: n/a
zib-patient-v3.2-2020EN: NL-CM:0.1.33
zib-patient-v3.2-2020EN: NL-CM:0.1.32

address

1..1

There are no (further) constraints on this element

Element id

Patient.address

Short description

AddressInformation

Alternate names

Adresgegevens

Definition

Patient's address information.

Requirements

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

Comments

This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the zib AddressInformation v1.1 (2020). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

Separate address parts

The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.

Custom address types

The second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The code from the zib should also be included using the extension on Address.extension:addressType.

zib	.ext:addressType	.use	.type
Postal Address/Postadres	PST		postal
Primary Home/Officieel adres	HP	home	both
Visit Address/Woon-/verblijfadres	PHYS	home	physical
Temporary Address/Tijdelijk adres	TMP	temp
Work Place/Werkadres	WP	work
Vacation Home/Vakantie adres	HV	temp

If Address.type is both then this is to be understood as a dual purpose address (postal and physical), unless a specific postal type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.

Note: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

Data type

Constraints

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

Mappings

v2: PID-11
rim: addr
cda: .addr
rim: n/a
v2: XAD
rim: AD
servd: Address
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.1
zib-patient-v3.2-2020EN: NL-CM:0.1.4
zib-payer-v3.1.1-2020EN: NL-CM:1.1.17

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

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

addressType

0..1

There are no (further) constraints on this element

Element id

Patient.address.extension:addressType

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

http://nictiz.nl/fhir/StructureDefinition/ext-AddressInformation.AddressType

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.address.use

Short description

AddressType

Alternate names

AdresSoort

Definition

The type of address in question, such as a home address or mailing 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

AdresSoortCodelijst_to_AddressUse

Binding

Use ConceptMap AdresSoortCodelijst-to-AddressUse to translate terminology from the functional model to profile terminology in ValueSet AddressUse.

AddressUse (required)

Permitted Values

Constraints

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

Examples

General

home

Mappings

v2: XAD.7
rim: unique(./use)
servd: ./AddressPurpose
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.8

type

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.address.type

Short description

AddressType

Alternate names

AdresSoort

Definition

The type of address in question, such as a home address or mailing address.

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

AdresSoortCodelijst_to_AddressType

Binding

Use ConceptMap AdresSoortCodelijst-to-AddressType to translate terminology from the functional model to profile terminology in ValueSet AddressType.

AddressType (required)

Permitted Values

Constraints

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

Examples

General

both

Mappings

v2: XAD.18
rim: unique(./use)
vcard: address type parameter
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.8

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

Constraints

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

Examples

General

137 Nowhere Street, Erewhon 9132

Mappings

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

line

0..*

There are no (further) constraints on this element

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

The mapping of zib AddressInformation on the FHIR Address datatype is the result of compatibility with HL7v3, which is the format that a lot of healthcare data in the Netherlands is stored in.

The elements of Address stored in the address-part extensions will be ignored by applications that do not support them, so any information in them should also be duplicated in the Address.line to which they are attached. The value of Address.line should be populated with a complete string representation of all the separate extension values, like: "[Street] [HouseNumberIndication] [HouseNumber] [HouseNumberLetter] [HouseNumberAddition]".

Data type

Constraints

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

Examples

General

137 Nowhere Street

Mappings

v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
rim: AD.part[parttype = AL]
vcard: street
servd: ./StreetAddress (newline delimitted)

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references)

Data type

extension

0..*

There are no (further) constraints on this element

Element id

Patient.address.line.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

streetName

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:streetName

Short description

streetName

Alternate names

extensions, user content

Definition

streetName.

Comments

Data type

http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: ADXP[partType=STR]

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:streetName.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.address.line.extension:streetName.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.line.extension:streetName.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/iso21090-ADXP-streetName

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:streetName.value[x]

Short description

Street

Alternate names

Straat

Definition

Street name of the address.

Constraints

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

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.2

valueString

There are no (further) constraints on this element

Data type

houseNumber

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumber

Short description

houseNumber

Alternate names

extensions, user content

Definition

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

Comments

Data type

http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: ADXP[partType=BNR]

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumber.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.address.line.extension:houseNumber.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumber.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/iso21090-ADXP-houseNumber

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumber.value[x]

Short description

HouseNumber

Alternate names

Huisnummer

Definition

House number of the address.

Constraints

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

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.12

valueString

There are no (further) constraints on this element

Data type

houseNumberLetter-houseNumberAddition

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberLetter-houseNumberAddition

Short description

buildingNumberSuffix

Alternate names

extensions, user content

Definition

Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number.

Comments

Data type

http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: ADXP[partType=BNS]

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberLetter-houseNumberAddition.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.address.line.extension:houseNumberLetter-houseNumberAddition.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberLetter-houseNumberAddition.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/iso21090-ADXP-buildingNumberSuffix

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberLetter-houseNumberAddition.value[x]

Short description

HouseNumberLetter / HouseNumberAddition

Alternate names

Huisnummerletter, Huisnummertoevoeging

Definition

Export:

If a HouseNumberLetter as well as a HouseNumberAddition is known: HouseNumberLetter first, followed by a space and finally the HouseNumberAddition.
If only a HouseNumberLetter is known, send just that. No trailing space is required.
If only a HouseNumberAddition is known, communicate that with a leading space.

Import

If the value of buildingNumberSuffix contains no space, then the whole value is considered to be the HouseNumberLetter.
If the value of buildingNumberSuffix contains a space, then everything before the first space is considered to be the HouseNumberLetter, and the everything trailing the first space is considered to be the HouseNumberAddition.

Note: While a leading space is allowed in string values in FHIR, the parsing of such space cannot be guaranteed in XML representations. Although aware of this issue, this mapping is not changed because of compatibility reasons. If an implementer cannot parse a leading space, the practical risk of mapping a HouseNumberIndication to a HouseNumberAddition is deemed insignificant.

Constraints

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

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.11
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.10

valueString

There are no (further) constraints on this element

Data type

houseNumberIndication

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberIndication

Short description

additionalLocator

Alternate names

extensions, user content

Definition

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).

Comments

Data type

http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: ADXP[partType=ADL]

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberIndication.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.address.line.extension:houseNumberIndication.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberIndication.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/iso21090-ADXP-additionalLocator

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:houseNumberIndication.value[x]

Short description

HouseNumberIndication

Alternate names

AanduidingBijNummer

Definition

The indication used for addresses which do not consist of the usual street name and house number.

Comments

The mapping of zib AddressInformation on the FHIR Address datatype is the result of compatibility with HL7v3, which is the format that a lot of healthcare data in the Netherlands is stored in. As a result of this, the coded zib HouseNumberIndication concept (CD datatype) is mapped to a FHIR string datatype with a constraint added (the value can only be 'by' or 'to').

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
houseNumberIndication: Must have value 'by' or 'to'
$this in ('by' | 'to')

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.9

valueString

There are no (further) constraints on this element

Data type

additionalInformation

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:additionalInformation

Short description

unitID

Alternate names

extensions, user content

Definition

The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.

Comments

Data type

http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: ADXP[partType=UNID]

0..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:additionalInformation.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.address.line.extension:additionalInformation.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.line.extension:additionalInformation.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/iso21090-ADXP-unitID

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.address.line.extension:additionalInformation.value[x]

Short description

AdditionalInformation

Alternate names

AdditioneleInformatie

Definition

Extra information such as the building name, building number, entrance, route number.

Constraints

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

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.7

valueString

There are no (further) constraints on this element

Data type

value

0..1

System.String

There are no (further) constraints on this element

Element id

Patient.address.line.value

Short description

Primitive value for string

Definition

The actual value

Data type

System.String

Maximum string length

1048576

city

0..1

There are no (further) constraints on this element

Element id

Patient.address.city

Short description

PlaceOfResidence

Alternate names

Municpality, Woonplaats

Definition

A geographically determined area which forms part of the municipal area. For Dutch places of residence, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

Data type

Constraints

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

Examples

General

Erewhon

Mappings

v2: XAD.3
rim: AD.part[parttype = CTY]
vcard: locality
servd: ./Jurisdiction
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.3

district

0..1

There are no (further) constraints on this element

Element id

Patient.address.district

Short description

Municipality

Alternate names

County, Gemeente

Definition

Municipality of residence. For Dutch municipalities, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

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

Constraints

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

Examples

General

Madison

Mappings

v2: XAD.9
rim: AD.part[parttype = CNT | CPA]
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.4

state

0..1

There are no (further) constraints on this element

Element id

Patient.address.state

Short description

Sub-unit of country (abbreviations ok)

Alternate names

Province, Territory

Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Data type

Constraints

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

Mappings

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

postalCode

0..1

There are no (further) constraints on this element

Element id

Patient.address.postalCode

Short description

Postcode

Alternate names

Zip, Postcode

Definition

Postcode of the address. In Dutch addresses, preferably use the postcode from the Postcode table (OID: 2.16.840.1.113883.2.4.4.15).

Data type

Constraints

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

Examples

General

Mappings

v2: XAD.5
rim: AD.part[parttype = ZIP]
vcard: code
servd: ./PostalIdentificationCode
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.6

country

1..1

stringBinding

Element id

Patient.address.country

Short description

Country (e.g. can be ISO 3166 2 or 3 letter code)

Definition

Country - a nation as commonly understood or generally accepted.

Comments

The FHIR datatype does not properly support coding the country using a CodeableConcept or Coding datatype. If the sender supports coded countries, it SHALL send the coded value using the ext-CodeSpecification extension under Address.country.extension:countryCode.

Data type

Binding

Country code (required)

Constraints

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

Mappings

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

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references)

Data type

extension

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

countryCode

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.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.country.extension:countryCode.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.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://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

Mappings

rim: N/A

value[x]

0..1

Binding

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.value[x]

Short description

Country

Alternate names

Land

Definition

Country in which the address is located.

Binding

LandCodelijsten (required)

Constraints

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

Mappings

rim: N/A
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.5

valueCodeableConcept

There are no (further) constraints on this element

Data type

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.value[x].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.country.extension:countryCode.value[x].extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

coding

0..*

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.value[x].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

Constraints

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

Mappings

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.address.country.extension:countryCode.value[x].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.address.country.extension:countryCode.value[x].coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

system

0..1

uriFixed Value

Element id

Patient.address.country.extension:countryCode.value[x].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

Constraints

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

Fixed value

urn:oid:2.16.840.1.113883.2.4.4.16.34

Mappings

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.address.country.extension:countryCode.value[x].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

Constraints

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

Mappings

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

code

0..1

codeBinding

Element id

Patient.address.country.extension:countryCode.value[x].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.

Data type

Binding

Country code (required)

Constraints

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

Mappings

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

display

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.value[x].coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

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

Mappings

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.address.country.extension:countryCode.value[x].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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

Patient.address.country.extension:countryCode.value[x].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

Constraints

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

Mappings

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

value

0..1

System.String

There are no (further) constraints on this element

Element id

Patient.address.country.value

Short description

Primitive value for string

Definition

The actual value

Data type

System.String

Maximum string length

1048576

period

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.

Data type

Constraints

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

Examples

General

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

Mappings

v2: XAD.12 / XAD.13 + XAD.14
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate

maritalStatus

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.maritalStatus

Short description

MaritalStatus

Alternate names

BurgerlijkeStaat

Definition

A person’s marital status according to the terms and definition in the Dutch civil code.

Requirements

Most, if not all systems capture it.

Data type

BurgerlijkeStaatCodelijst (required)

Binding

BurgerlijkeStaatCodelijst

Constraints

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

Mappings

v2: PID-16
rim: player[classCode=PSN]/maritalStatusCode
cda: .patient.maritalStatusCode
zib-maritalstatus-v3.1-2020EN: NL-CM:7.9.2

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).

Sliced:

Unordered, Open, by $this(Type)

Constraints

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

Mappings

v2: PID-24 (bool), PID-25 (integer)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
cda: n/a

(All Slices)

There are no (further) constraints on this element

multipleBirthInteger

integer

There are no (further) constraints on this element

Data type

integer

multipleBirthBoolean

0..1

There are no (further) constraints on this element

Element id

Patient.multipleBirth[x]:multipleBirthBoolean

Short description

MultipleBirthIndicator

Alternate names

MeerlingIndicator

Definition

An indication stating whether the patient is of a multiple birth.

Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Data type

Constraints

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

Mappings

v2: PID-24 (bool), PID-25 (integer)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
cda: n/a
zib-patient-v3.2-2020EN: NL-CM:0.1.31

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

Constraints

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

Mappings

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

contact

0..*

There are no (further) constraints on this element

Element id

Patient.contact

Short description

Contact

Alternate names

Contactpersoon

Definition

A contact party (e.g. guardian, partner, friend) for the patient.

Requirements

Need to track people you can contact about the patient.

Comments

Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:

The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile http://nictiz.nl/fhir/StructureDefinition/zib-ContactPerson.
Information about persons that should be contacted regarding the care for the patient is captured using the Patient.contact resource.

If a person is both a related person and a contact person, then some data duplication is inevitable. The zib-ContactPerson can be referenced using the extension in contact:contactPerson.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
pat-1: SHALL at least contain a contact's details or a reference to an organization
name.exists() or telecom.exists() or address.exists() or organization.exists()

Mappings

rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
cda: n/a
zib-contactperson-v3.4-2020EN: NL-CM:3.1.1

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

http://hl7.org/fhir/StructureDefinition/patient-relatedPerson

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

contactPerson

0..1

Extension(Reference(RelatedPerson))

There are no (further) constraints on this element

Element id

Patient.contact.extension:contactPerson

Short description

This contact may have further details in this RelatedPerson

Alternate names

extensions, user content

Definition

In some cases a Patient.contact will also be populated as a RelatedPerson resource. This linkage permits the linkage between the 2 resources to be able to accurately indicate a representation of the same individual, and updating details between could be appropriate.

Comments

Data type

Extension(Reference(RelatedPerson))

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

0..1

There are no (further) constraints on this element

Element id

Patient.contact.extension:contactPerson.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.contact.extension:contactPerson.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.extension:contactPerson.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/patient-relatedPerson

Mappings

rim: N/A

value[x]

1..1

There are no (further) constraints on this element

Element id

Patient.contact.extension:contactPerson.value[x]

Short description

Contact

Alternate names

Contactpersoon

Definition

Reference to a zib-ContactPerson instance containing the full details for the current contact.

Constraints

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

Mappings

rim: N/A
zib-contactperson-v3.4-2020EN: NL-CM:3.1.1

valueReference

There are no (further) constraints on this element

Data type

modifierExtension

Σ ?! I

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

relationship

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.contact.relationship

Short description

The kind of relationship

Definition

The nature of the relationship between the patient and the contact person.

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Data type

PatientContactRelationship (extensible)

Sliced:

Unordered, Open, by $this(Value)

Binding

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

Constraints

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

Mappings

v2: NK1-7, NK1-3
rim: code
cda: n/a

role

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.contact.relationship:role

Short description

Role

Alternate names

Rol

Definition

Defines the role of the contact in relation to the patient.

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Data type

Binding

RolCodelijst

RolCodelijst (required)

Constraints

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

Mappings

v2: NK1-7, NK1-3
rim: code
cda: n/a
zib-contactperson-v3.4-2020EN: NL-CM:3.1.2

relationship

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.contact.relationship:relationship

Short description

Relationship

Alternate names

Relatie

Definition

Defines the contact’s familial relationship to the patient.

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Data type

Binding

RelatieCodelijst

RelatieCodelijst (required)

Constraints

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

Mappings

v2: NK1-7, NK1-3
rim: code
cda: n/a
zib-contactperson-v3.4-2020EN: NL-CM:3.1.3

name

0..1

There are no (further) constraints on this element

Element id

Patient.contact.name

Short description

NameInformation

Alternate names

Naamgegevens

Definition

Full name of the contact.

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

This element can and should not completely capture the NameInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full name information should instead be captured using an instance of zib-ContactPerson, which can then be referenced from this resource. See the comment on Patient.contact for more information.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
zib-NameInformation-1: If a prefix for a family name is specified, the family name is expected as well
family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()
zib-NameInformation-2: If the prefix for a partner family name is specified, the partner family name is expected as well
family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()

Mappings

v2: NK1-2
rim: name
cda: n/a
rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
zib-nameinformation-v1.1-2020EN: NL-CM:20.4.1
zib-contactperson-v3.4-2020EN: NL-CM:3.1.4

telecom

0..*

There are no (further) constraints on this element

Element id

Patient.contact.telecom

Short description

ContactInformation

Alternate names

Contactgegevens

Definition

The contact’s telephone number and/or e-mail address.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Data type

Sliced:

Unordered, Open, by $this(Profile)

Constraints

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

Mappings

v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a
zib-contactperson-v3.4-2020EN: NL-CM:3.1.6
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.1

telephoneNumbers

0..*

There are no (further) constraints on this element

Element id

Patient.contact.telecom:telephoneNumbers

Short description

TelephoneNumbers

Alternate names

Telefoonnummers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

Data type

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

v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.2

emailAddresses

0..*

There are no (further) constraints on this element

Element id

Patient.contact.telecom:emailAddresses

Short description

EmailAddresses

Alternate names

EmailAdressen

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

Data type

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

v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
zib-contactinformation-v1.2-2020EN: NL-CM:20.6.3

address

0..1

There are no (further) constraints on this element

Element id

Patient.contact.address

Short description

AddressInformation

Alternate names

Adresgegevens

Definition

Contact’s address information.

Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Comments

This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of zib-ContactPerson, which can then be referenced from this resource. See the comment on Patient.contact for more information.

Data type

Constraints

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

Mappings

v2: NK1-4
rim: addr
cda: n/a
rim: n/a
v2: XAD
rim: AD
servd: Address
zib-addressinformation-v1.1-2020EN: NL-CM:20.5.1
zib-contactperson-v3.4-2020EN: NL-CM:3.1.5

gender

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.contact.gender

Short description

male | female | other | unknown

Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Requirements

Needed to address the person correctly.

Data type

AdministrativeGender (required)

Binding

The gender of a person used for administrative purposes.

Constraints

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

Mappings

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

organization

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.

Data type

Constraints

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

Mappings

v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
rim: scoper
cda: n/a

period

0..1

There are no (further) constraints on this element

Element id

Patient.contact.period

Short description

The period during which this contact person or organization is valid to be contacted relating to this patient

Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Data type

Constraints

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

Mappings

rim: effectiveTime
cda: n/a

communication

0..*

There are no (further) constraints on this element

Element id

Patient.communication

Short description

LanguageProficiency

Alternate names

Taalvaardigheid

Definition

A language which may be used to communicate with the patient about his or her health.

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Data type

Constraints

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

Mappings

rim: LanguageCommunication
cda: patient.languageCommunication
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.1

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

http://hl7.org/fhir/StructureDefinition/patient-proficiency

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

languageControl

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl

Short description

LanguageControlListening / LanguageControlSpeaking / LanguageControlReading

Alternate names

extensions, user content, TaalvaardigheidBegrijpen, TaalvaardigheidSpreken, TaalvaardigheidLezen

Definition

The ability to understand spoken text in the language in question. The ability to express oneself in spoken language. The ability to understand written text in he language in question.

Comments

The zib concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captured using a core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping:

LanguageControlListening maps to code 'RSP' (Received spoken)
LanguageControlReading maps to code 'RWR' (Received written)
LanguageControlSpeaking maps to code 'ESP' (Expressed spoken)

Data type

Extension(Complex)

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.6
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.7
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.8

0..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.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

2..*

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

level

1..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension:level

Short description

The proficiency level of the communication

Definition

How well the patient can communicate this communication (good, poor, etc.).

Data type

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()

0..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension:level.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.communication.extension:languageControl.extension:level.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension:level.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

v3.LanguageAbilityProficiency (required)

Fixed value

level

Mappings

rim: N/A

value[x]

1..1

Binding

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension:level.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).

Comments

The zib ValueSets TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidSprekenCodelijst and TaalvaardigheidLezenCodelijst are equal to the default FHIR ValueSet.

Binding

The proficiency level for the communication.

Constraints

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

Mappings

rim: N/A

valueCoding

There are no (further) constraints on this element

Data type

type

1..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.extension:type

Short description

The proficiency type of the communication

Definition

What type of communication for the proficiency (spoken, written, etc.).

Data type

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()

0..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.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.communication.extension:languageControl.extension:type.extension

Short description

Extension

Definition

An Extension

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.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

v3.LanguageAbilityMode (preferred)

Fixed value

type

Mappings

rim: N/A

value[x]

1..1

Binding

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.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

The proficiency type for the communication.

Constraints

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

Mappings

rim: N/A

valueCoding

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.communication.extension:languageControl.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/patient-proficiency

Mappings

rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageControl.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).

Constraints

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

Mappings

rim: N/A

communicationDetails

0..*

There are no (further) constraints on this element

Element id

Patient.communication.extension:communicationDetails

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

http://nictiz.nl/fhir/StructureDefinition/ext-LanguageProficiency.CommunicationDetails

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

comment

0..1

There are no (further) constraints on this element

Element id

Patient.communication.extension:comment

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

http://nictiz.nl/fhir/StructureDefinition/ext-Comment

Extension URL

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

There are no (further) constraints on this element

Element id

Patient.communication.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..*

There are no (further) constraints on this element

Element id

Patient.communication.extension:comment.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.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

http://nictiz.nl/fhir/StructureDefinition/ext-Comment

Mappings

rim: N/A

value[x]

0..1

There are no (further) constraints on this element

Element id

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

Short description

Comment

Alternate names

Toelichting

Definition

A comment on the linguistic proficiency. When using sign language, this field can be used to clarify, for example, which sign language is used. This can be informative, as there is not always a one-to-one relationship between the spoken language and sign language.

Constraints

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

Mappings

rim: N/A
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.5

valueString

There are no (further) constraints on this element

Data type

modifierExtension

Σ ?! I

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

language

1..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.communication.language

Short description

CommunicationLanguage

Alternate names

CommunicatieTaal

Definition

The language of communication.

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

CommunicatieTaalCodelijst (required)

Binding

CommunicatieTaalCodelijst

Constraints

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

Mappings

v2: PID-15, LAN-2
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
cda: .languageCode
zib-languageproficiency-v3.2-2020EN: NL-CM:7.12.3

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

Constraints

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

Mappings

v2: PID-15
rim: preferenceInd
cda: .preferenceInd

generalPractitioner

0..*

Reference(Organization | Practitioner | PractitionerRole)

There are no (further) constraints on this element

Element id

Patient.generalPractitioner

Short description

Patient's nominated primary care provider

Alternate names

careProvider

Definition

Patient's nominated care provider.

Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

Data type

Reference(Organization | Practitioner | PractitionerRole)

Constraints

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

Mappings

v2: PD1-4
rim: subjectOf.CareEvent.performer.AssignedEntity
cda: n/a

managingOrganization

1..1

There are no (further) constraints on this element

Element id

Patient.managingOrganization

Short description

Organization that is the custodian of the patient record

Definition

Organization that is the custodian of the patient record.

Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Data type

Constraints

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

Mappings

rim: scoper
cda: .providerOrganization

link

Σ ?!

0..*

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

Constraints

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

Mappings

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

modifierExtension

Σ ?! I

0..*

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

other

1..1

Reference(Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Patient.link.other

Short description

The other patient or related person resource that the link refers to

Definition

The other patient resource that the link refers to.

Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Data type

Reference(Patient | RelatedPerson)

Constraints

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

Mappings

v2: PID-3, MRG-1
rim: id
cda: n/a

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.

Data type