CancerPatient Profile

Resource overview

This profile sets minimum expectations for the Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient for Lung Cancer Screening. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

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CancerPatient (Patient)
I
Patient
There are no (further) constraints on this element
Element id
Patient
Short description 
Information about an individual or animal receiving health care services
Alternate names 
SubjectOfCare Client Resident
Definition 
Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Data type 
Patient
Constraints
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()
Mappings
rim: Entity. Role, or Act
rim: Patient[classCode=PAT]
cda: ClinicalDocument.recordTarget.patientRole
id
Σ
0..1
string
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 
string
meta
Σ
0..1
Meta
There are no (further) constraints on this element
Element id
Patient.meta
Short description 
Metadata about the resource
Definition 
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Data type 
Meta
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
rim: N/A
implicitRules
Σ ?!
0..1
uri
There are no (further) constraints on this element
Element id
Patient.implicitRules
Short description 
A set of rules under which this content was created
Definition 
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Comments 
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Data type 
uri
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
language
0..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.language
Short description 
Language of the resource content
Definition 
The base language in which the resource is written.
Comments 
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Data type 
code
Binding 
A human language.
CommonLanguages (preferred)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
text
0..1
Narrative
There are no (further) constraints on this element
Element id
Patient.text
Short description 
Text summary of the resource, for human interpretation
Alternate names 
narrative, html, xhtml, display
Definition 
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Comments 
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Data type 
Narrative
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
rim: N/A
rim: Act.text?
contained
0..*
Resource
There are no (further) constraints on this element
Element id
Patient.contained
Short description 
Contained, inline Resources
Alternate names 
inline resources, anonymous resources, contained resources
Definition 
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Comments 
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Data type 
Resource
Mappings
rim: Entity. Role, or Act
rim: N/A
extension
I
0..*
Extension
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 
Extension
Sliced: 
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
modifierExtension
?! I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.modifierExtension
Short description 
Extensions that cannot be ignored
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Requirements 
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
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
rim: N/A
identifier
S Σ
1..*
Identifier
There are no (further) constraints on this element
Element id
Patient.identifier
Short description 
An identifier for this patient
Definition 
An identifier for this patient.
Requirements 
Patients are almost always assigned specific numerical identifiers.
Data type 
Identifier
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]
servd: Identifier
w5: FiveWs.identifier
v2: PID-3
rim: id
cda: .id
active
Σ ?!
0..1
boolean
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 
boolean
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
w5: FiveWs.status
rim: statusCode
cda: n/a
name
Σ I
1..*
HumanName
Element id
Patient.name
Short description 
A name associated with the patient
Definition 
A name associated with the individual.
Requirements 
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
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
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
name-required: Either a given name MUST be provided or a family name MUST include
family.exists() or given.exists()
Mappings
rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: PID-5, PID-9
rim: name
cda: .patient.name
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.name.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.name.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Sliced: 
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
use
Σ ?!
0..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.name.use
Short description 
usual | official | temp | nickname | anonymous | old | maiden
Definition 
Identifies the purpose for this name.
Requirements 
Allows the appropriate name for a particular context of use to be selected from among a set of names.
Comments 
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Data type 
code
Binding 
The use of a human name.
NameUse (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN.7, but often indicated by which field contains the name
rim: unique(./use)
servd: ./NamePurpose
text
Σ
0..1
string
There are no (further) constraints on this element
Element id
Patient.name.text
Short description 
Text representation of the full name
Definition 
Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
Requirements 
A renderable, unencoded form.
Comments 
Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present,  no content is included in the text that isn't found in a part.
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: implied by XPN.11
rim: ./formatted
family
S Σ
0..1
string
There are no (further) constraints on this element
Element id
Patient.name.family
Short description 
Family name (often called 'Surname')
Alternate names 
surname
Definition 
The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Comments 
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN.1/FN.1
rim: ./part[partType = FAM]
servd: ./FamilyName
given
S Σ
0..*
string
There are no (further) constraints on this element
Element id
Patient.name.given
Short description 
Given names (not always 'first'). Includes middle names
Alternate names 
first name, middle name
Definition 
Given name.
Comments 
If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations.  This element is not called "first name" since given names do not always come first.
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN.2 + XPN.3
rim: ./part[partType = GIV]
servd: ./GivenNames
prefix
Σ
0..*
string
There are no (further) constraints on this element
Element id
Patient.name.prefix
Short description 
Parts that come before the name
Definition 
Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN.5
rim: ./part[partType = PFX]
servd: ./TitleCode
suffix
Σ
0..*
string
There are no (further) constraints on this element
Element id
Patient.name.suffix
Short description 
Parts that come after the name
Definition 
Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN/4
rim: ./part[partType = SFX]
period
Σ I
0..1
Period
There are no (further) constraints on this element
Element id
Patient.name.period
Short description 
Time period when name was/is in use
Definition 
Indicates the period of time when this name was valid for the named person.
Requirements 
Allows names to be placed in historical context.
Comments 
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type 
Period
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: XPN.13 + XPN.14
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate
telecom
Σ I
1..*
ContactPoint
Element id
Patient.telecom
Short description 
A contact detail for the individual
Definition 
A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Requirements 
People have (primary) ways to contact them in some way such as phone, email.
Comments 
A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Data type 
ContactPoint
Sliced: 
Unordered, Open, by system(Value), use(Value)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
Mappings
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
phone
Σ I
0..*
ContactPoint
There are no (further) constraints on this element
Element id
Patient.telecom:phone
Short description 
A contact detail for the individual
Definition 
A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Requirements 
People have (primary) ways to contact them in some way such as phone, email.
Comments 
A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Data type 
ContactPoint
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
Mappings
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.telecom:phone.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.telecom:phone.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Sliced: 
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
system
Σ I
1..1
codeBindingFixed Value
Element id
Patient.telecom:phone.system
Short description 
phone | fax | email | pager | url | sms | other
Definition 
Telecommunications form for contact point - what communications system is required to make use of the contact.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
code
Binding 
Telecommunications form for contact point.
ContactPointSystem (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed value 
phone
Mappings
rim: n/a
v2: XTN.3
rim: ./scheme
servd: ./ContactPointType
value
Σ
0..1
string
There are no (further) constraints on this element
Element id
Patient.telecom:phone.value
Short description 
The actual contact point details
Definition 
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Requirements 
Need to support legacy numbers that are not in a tightly controlled format.
Comments 
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XTN.1 (or XTN.12)
rim: ./url
servd: ./Value
use
Σ ?!
1..1
codeBindingFixed Value
Element id
Patient.telecom:phone.use
Short description 
home | work | temp | old | mobile - purpose of this contact point
Definition 
Identifies the purpose for the contact point.
Requirements 
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Comments 
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Data type 
code
Binding 
Use of contact point.
ContactPointUse (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed value 
mobile
Mappings
rim: n/a
v2: XTN.2 - but often indicated by field
rim: unique(./use)
servd: ./ContactPointPurpose
rank
Σ
0..1
positiveInt
There are no (further) constraints on this element
Element id
Patient.telecom:phone.rank
Short description 
Specify preferred order of use (1 = highest)
Definition 
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Comments 
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Data type 
positiveInt
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: n/a
period
Σ I
0..1
Period
There are no (further) constraints on this element
Element id
Patient.telecom:phone.period
Short description 
Time period when the contact point was/is in use
Definition 
Time period when the contact point was/is in use.
Comments 
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type 
Period
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: N/A
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate
email
Σ I
0..*
ContactPoint
There are no (further) constraints on this element
Element id
Patient.telecom:email
Short description 
A contact detail for the individual
Definition 
A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Requirements 
People have (primary) ways to contact them in some way such as phone, email.
Comments 
A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Data type 
ContactPoint
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
Mappings
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.telecom:email.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.telecom:email.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Sliced: 
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) url
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
system
Σ I
1..1
codeBindingFixed Value
Element id
Patient.telecom:email.system
Short description 
phone | fax | email | pager | url | sms | other
Definition 
Telecommunications form for contact point - what communications system is required to make use of the contact.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
code
Binding 
Telecommunications form for contact point.
ContactPointSystem (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed value 
email
Mappings
rim: n/a
v2: XTN.3
rim: ./scheme
servd: ./ContactPointType
value
Σ
0..1
string
There are no (further) constraints on this element
Element id
Patient.telecom:email.value
Short description 
The actual contact point details
Definition 
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Requirements 
Need to support legacy numbers that are not in a tightly controlled format.
Comments 
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Data type 
string
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XTN.1 (or XTN.12)
rim: ./url
servd: ./Value
use
Σ ?!
0..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.telecom:email.use
Short description 
home | work | temp | old | mobile - purpose of this contact point
Definition 
Identifies the purpose for the contact point.
Requirements 
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Comments 
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Data type 
code
Binding 
Use of contact point.
ContactPointUse (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XTN.2 - but often indicated by field
rim: unique(./use)
servd: ./ContactPointPurpose
rank
Σ
0..1
positiveInt
There are no (further) constraints on this element
Element id
Patient.telecom:email.rank
Short description 
Specify preferred order of use (1 = highest)
Definition 
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Comments 
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Data type 
positiveInt
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: n/a
period
Σ I
0..1
Period
There are no (further) constraints on this element
Element id
Patient.telecom:email.period
Short description 
Time period when the contact point was/is in use
Definition 
Time period when the contact point was/is in use.
Comments 
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type 
Period
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: N/A
rim: ./usablePeriod[type="IVL<TS>"]
servd: ./StartDate and ./EndDate
gender
S Σ
0..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.gender
Short description 
male | female | other | unknown
Definition 
Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
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 
code
Binding 
The gender of a person used for administrative purposes.
AdministrativeGender (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: PID-8
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
cda: .patient.administrativeGenderCode
birthDate
Σ
0..1
date
There are no (further) constraints on this element
Element id
Patient.birthDate
Short description 
The date of birth for the individual
Definition 
The date of birth for the individual.
Requirements 
Age of the individual drives many clinical processes.
Comments 
At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
Data type 
date
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: PID-7
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
cda: .patient.birthTime
loinc: 21112-8
deceased[x]
S Σ ?!
0..1
There are no (further) constraints on this element
Element id
Patient.deceased[x]
Short description 
Indicates if the individual is deceased or not
Definition 
Indicates if the individual is deceased or not.
Requirements 
The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Comments 
If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: PID-30  (bool) and PID-29 (datetime)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
cda: n/a
deceasedBoolean
boolean
There are no (further) constraints on this element
Data type 
boolean
deceasedDateTime
dateTime
There are no (further) constraints on this element
Data type 
dateTime
address
Σ
0..*
Address
There are no (further) constraints on this element
Element id
Patient.address
Short description 
An address for the individual
Definition 
An address for the individual.
Requirements 
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Comments 
Patient may have multiple addresses with different uses or applicable periods.
Data type 
Address
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XAD
rim: AD
servd: Address
v2: PID-11
rim: addr
cda: .addr
maritalStatus
0..1
CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.maritalStatus
Short description 
Marital (civil) status of a patient
Definition 
This field contains a patient's most recent marital (civil) status.
Requirements 
Most, if not all systems capture it.
Comments 
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Data type 
CodeableConcept
Binding 
The domestic partnership status of a person.
Marital Status Codes (extensible)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PID-16
rim: player[classCode=PSN]/maritalStatusCode
cda: .patient.maritalStatusCode
multipleBirth[x]
0..1
There are no (further) constraints on this element
Element id
Patient.multipleBirth[x]
Short description 
Whether patient is part of a multiple birth
Definition 
Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Requirements 
For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Comments 
Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: PID-24 (bool), PID-25 (integer)
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
cda: n/a
multipleBirthBoolean
boolean
There are no (further) constraints on this element
Data type 
boolean
multipleBirthInteger
integer
There are no (further) constraints on this element
Data type 
integer
photo
I
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())
att-1: If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()
Mappings
rim: n/a
v2: ED/RP
rim: ED
v2: OBX-5 - needs a profile
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
cda: n/a
contact
I
0..*
BackboneElement
There are no (further) constraints on this element
Element id
Patient.contact
Short description 
A contact party (e.g. guardian, partner, friend) for the patient
Definition 
A contact party (e.g. guardian, partner, friend) for the patient.
Requirements 
Need to track people you can contact about the patient.
Comments 
Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Data type 
BackboneElement
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
pat-1: SHALL at least contain a contact's details or a reference to an organization
name.exists() or telecom.exists() or address.exists() or organization.exists()
Mappings
rim: n/a
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
cda: n/a
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.contact.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.contact.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
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
rim: N/A
modifierExtension
Σ ?! I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.contact.modifierExtension
Short description 
Extensions that cannot be ignored even if unrecognized
Alternate names 
extensions, user content, modifiers
Definition 
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Requirements 
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
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.
Comments 
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Data type 
CodeableConcept
Binding 
The nature of the relationship between a patient and a contact person for that patient.
PatientContactRelationship (extensible)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: NK1-7, NK1-3
rim: code
cda: n/a
name
0..1
HumanName
There are no (further) constraints on this element
Element id
Patient.contact.name
Short description 
A name associated with the contact person
Definition 
A name associated with the contact person.
Requirements 
Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Comments 
Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
Data type 
HumanName
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: NK1-2
rim: name
cda: n/a
telecom
I
0..*
ContactPoint
There are no (further) constraints on this element
Element id
Patient.contact.telecom
Short description 
A contact detail for the person
Definition 
A contact detail for the person, e.g. a telephone number or an email address.
Requirements 
People have (primary) ways to contact them in some way such as phone, email.
Comments 
Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.
Data type 
ContactPoint
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
Mappings
rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a
address
0..1
Address
There are no (further) constraints on this element
Element id
Patient.contact.address
Short description 
Address for the contact person
Definition 
Address for the contact person.
Requirements 
Need to keep track where the contact person can be contacted per postal mail or visited.
Comments 
Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates.  Postal addresses are often used as proxies for physical locations (also see the Location resource).
Data type 
Address
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: XAD
rim: AD
servd: Address
v2: NK1-4
rim: addr
cda: n/a
gender
0..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.contact.gender
Short description 
male | female | other | unknown
Definition 
Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Requirements 
Needed to address the person correctly.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
code
Binding 
The gender of a person used for administrative purposes.
AdministrativeGender (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: NK1-15
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
cda: n/a
organization
I
0..1
Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.contact.organization
Short description 
Organization that is associated with the contact
Definition 
Organization on behalf of which the contact is acting or for which the contact is working.
Requirements 
For guardians or business related contacts, the organization is relevant.
Comments 
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data type 
Reference(Organization)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
rim: scoper
cda: n/a
period
I
0..1
Period
There are no (further) constraints on this element
Element id
Patient.contact.period
Short description 
The period during which this contact person or organization is valid to be contacted relating to this patient
Definition 
The period during which this contact person or organization is valid to be contacted relating to this patient.
Comments 
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type 
Period
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
rim: effectiveTime
cda: n/a
communication
0..*
BackboneElement
There are no (further) constraints on this element
Element id
Patient.communication
Short description 
A language which may be used to communicate with the patient about his or her health
Definition 
A language which may be used to communicate with the patient about his or her health.
Requirements 
If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
Comments 
If no language is specified, this implies that the default local language is spoken.  If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
Data type 
BackboneElement
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
rim: LanguageCommunication
cda: patient.languageCommunication
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.communication.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.communication.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
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
rim: N/A
modifierExtension
Σ ?! I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.communication.modifierExtension
Short description 
Extensions that cannot be ignored even if unrecognized
Alternate names 
extensions, user content, modifiers
Definition 
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Requirements 
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
language
1..1
CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.communication.language
Short description 
The language which can be used to communicate with the patient about his or her health
Definition 
The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Requirements 
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Comments 
The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Data type 
CodeableConcept
Binding 
A human language.
CommonLanguages (preferred)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PID-15, LAN-2
rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
cda: .languageCode
preferred
0..1
boolean
There are no (further) constraints on this element
Element id
Patient.communication.preferred
Short description 
Language preference indicator
Definition 
Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Requirements 
People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.
Comments 
This language is specifically identified for communicating healthcare information.
Data type 
boolean
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: PID-15
rim: preferenceInd
cda: .preferenceInd
generalPractitioner
I
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())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PD1-4
rim: subjectOf.CareEvent.performer.AssignedEntity
cda: n/a
managingOrganization
Σ I
0..1
Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.managingOrganization
Short description 
Organization that is the custodian of the patient record
Definition 
Organization that is the custodian of the patient record.
Requirements 
Need to know who recognizes this patient record, manages and updates it.
Comments 
There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
Data type 
Reference(Organization)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: scoper
cda: .providerOrganization
link
Σ ?!
0..*
BackboneElement
There are no (further) constraints on this element
Element id
Patient.link
Short description 
Link to another patient resource that concerns the same actual person
Definition 
Link to another patient resource that concerns the same actual patient.
Requirements 
There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

Comments 
There is no assumption that linked patient records have mutual links.
Data type 
BackboneElement
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
rim: outboundLink
cda: n/a
id
0..1
string
There are no (further) constraints on this element
Element id
Patient.link.id
Short description 
Unique id for inter-element referencing
Definition 
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type 
string
Mappings
rim: n/a
extension
I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.link.extension
Short description 
Additional content defined by implementations
Alternate names 
extensions, user content
Definition 
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
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
rim: N/A
modifierExtension
Σ ?! I
0..*
Extension
There are no (further) constraints on this element
Element id
Patient.link.modifierExtension
Short description 
Extensions that cannot be ignored even if unrecognized
Alternate names 
extensions, user content, modifiers
Definition 
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Requirements 
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments 
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type 
Extension
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings
rim: n/a
rim: N/A
other
Σ I
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())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PID-3, MRG-1
rim: id
cda: n/a
type
Σ
1..1
codeBinding
There are no (further) constraints on this element
Element id
Patient.link.type
Short description 
replaced-by | replaces | refer | seealso
Definition 
The type of link between this patient resource and another patient resource.
Comments 
Note that FHIR strings SHALL NOT exceed 1MB in size
Data type 
code
Binding 
The type of link between this patient resource and another patient resource.
LinkType (required)
Constraints
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings
rim: n/a
rim: typeCode
cda: n/a

Example resources.

The recommended way to link to other resources is by resource id. This will ensure that the links will keep working even when the guide is exported or duplicated. The rendering will work with Link, xml and json:

{ {Link/xml/json: ResourceType/id}} (without the space between the curly brackets)

For example MyPatientName MyPatient