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USCoreBirthSexExtension (Extension) | I | | Extension | Element idShort description Optional Extensions Element Definition Comments The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.
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
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- iso11179: .patient.administrativeGenderCode
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id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idShort 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 |
url | | 1..1 | uriFixed Value | Element idShort 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 uri Fixed value http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Mappings |
value[x] | | 0..1 | | There are no (further) constraints on this element Element idShort description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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 |
(All Slices) | | | | There are no (further) constraints on this element |
valueBase64Binary | | | base64Binary | There are no (further) constraints on this element Data type base64Binary |
valueBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
valueCanonical | | | canonical() | There are no (further) constraints on this element Data type canonical() |
valueDate | | | date | There are no (further) constraints on this element Data type date |
valueDateTime | | | dateTime | There are no (further) constraints on this element Data type dateTime |
valueDecimal | | | decimal | There are no (further) constraints on this element Data type decimal |
valueId | | | id | There are no (further) constraints on this element Data type id |
valueInstant | | | instant | There are no (further) constraints on this element Data type instant |
valueInteger | | | integer | There are no (further) constraints on this element Data type integer |
valueMarkdown | | | markdown | There are no (further) constraints on this element Data type markdown |
valueOid | | | oid | There are no (further) constraints on this element Data type oid |
valuePositiveInt | | | positiveInt | There are no (further) constraints on this element Data type positiveInt |
valueString | | | string | There are no (further) constraints on this element Data type string |
valueTime | | | time | There are no (further) constraints on this element Data type time |
valueUnsignedInt | | | unsignedInt | There are no (further) constraints on this element Data type unsignedInt |
valueUri | | | uri | There are no (further) constraints on this element Data type uri |
valueUrl | | | url | There are no (further) constraints on this element Data type url |
valueUuid | | | uuid | There are no (further) constraints on this element Data type uuid |
valueAddress | | | Address | There are no (further) constraints on this element Data type Address |
valueAge | | | Age | There are no (further) constraints on this element Data type Age |
valueAnnotation | | | Annotation | There are no (further) constraints on this element Data type Annotation |
valueAttachment | | | Attachment | There are no (further) constraints on this element Data type Attachment |
valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data type CodeableConcept |
valueCoding | | | Coding | There are no (further) constraints on this element Data type Coding |
valueContactPoint | | | ContactPoint | There are no (further) constraints on this element Data type ContactPoint |
valueCount | | | Count | There are no (further) constraints on this element Data type Count |
valueDistance | | | Distance | There are no (further) constraints on this element Data type Distance |
valueDuration | | | Duration | There are no (further) constraints on this element Data type Duration |
valueHumanName | | | HumanName | There are no (further) constraints on this element Data type HumanName |
valueIdentifier | | | Identifier | There are no (further) constraints on this element Data type Identifier |
valueMoney | | | Money | There are no (further) constraints on this element Data type Money |
valuePeriod | | | Period | There are no (further) constraints on this element Data type Period |
valueQuantity | | | Quantity | There are no (further) constraints on this element Data type Quantity |
valueRange | | | Range | There are no (further) constraints on this element Data type Range |
valueRatio | | | Ratio | There are no (further) constraints on this element Data type Ratio |
valueSampledData | | | SampledData | There are no (further) constraints on this element Data type SampledData |
valueSignature | | | Signature | There are no (further) constraints on this element Data type Signature |
valueTiming | | | Timing | There are no (further) constraints on this element Data type Timing |
valueContactDetail | | | ContactDetail | There are no (further) constraints on this element Data type ContactDetail |
valueContributor | | | Contributor | There are no (further) constraints on this element Data type Contributor |
valueDataRequirement | | | DataRequirement | There are no (further) constraints on this element Data type DataRequirement |
valueExpression | | | Expression | There are no (further) constraints on this element Data type Expression |
valueParameterDefinition | | | ParameterDefinition | There are no (further) constraints on this element Data type ParameterDefinition |
valueRelatedArtifact | | | RelatedArtifact | There are no (further) constraints on this element Data type RelatedArtifact |
valueTriggerDefinition | | | TriggerDefinition | There are no (further) constraints on this element Data type TriggerDefinition |
valueUsageContext | | | UsageContext | There are no (further) constraints on this element Data type UsageContext |
valueDosage | | | Dosage | There are no (further) constraints on this element Data type Dosage |
valueMeta | | | Meta | There are no (further) constraints on this element Data type Meta |
valueReference | | | Reference() | There are no (further) constraints on this element Data type Reference() |
valueCode | | 1..1 | codeBinding | Element idExtension.value[x]:valueCode 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).
Data type code Binding Code for sex assigned at birth
BirthSex (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
USCorePatientProfile (Patient) | I | | Patient | Element idShort description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.
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
- argonaut-dq-dstu2: Patient
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort 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 idShort 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 |
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idShort 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 |
language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort 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 CommonLanguages (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
text | | 0..1 | Narrative | There are no (further) constraints on this element Element idShort 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?
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contained | | 0..* | Resource | There are no (further) constraints on this element Element idShort 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 idShort 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 |
race | I | 0..1 | Extension(Complex) | Element idShort description US Core Race Extension Alternate names extensions, user content Definition Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White.
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(Complex) Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-race 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
- argonaut-dq-dstu2: Patient.extension
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ethnicity | I | 0..1 | Extension(Complex) | Element idPatient.extension:ethnicity Short description US Core ethnicity Extension Alternate names extensions, user content Definition Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.
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(Complex) Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity 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
- argonaut-dq-dstu2: Patient.extension
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birthsex | I | 0..1 | Extension(code) | Element idPatient.extension:birthsex Short description Optional Extensions Element Alternate names extensions, user content Definition Comments The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.
Data type Extension(code) Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex 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
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- iso11179: .patient.administrativeGenderCode
- argonaut-dq-dstu2: Patient.extension
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
identifier | S Σ | 1..* | Identifier | Element idShort 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
- argonaut-dq-dstu2: Patient.identifier
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id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data type code Binding Identifies the purpose for this identifier, if known .
IdentifierUse (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idShort description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identifier Type Codes (extensible)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
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system | S Σ | 1..1 | uri | Element idPatient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
- argonaut-dq-dstu2: Patient.identifier.system
|
value | S Σ | 1..1 | string | Element idShort description The value that is unique within the system. 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 string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: CX.1 / EI.1
- rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd: ./Value
- argonaut-dq-dstu2: Patient.identifier.value
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idPatient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data type 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: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data type Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - 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: 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
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idShort 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
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name | S Σ I | 1..* | HumanName | Element idShort 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()) - us-core-8: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present.
(family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
Mappings- rim: n/a
- v2: XPN
- rim: EN (actually, PN)
- servd: ProviderName
- v2: PID-5, PID-9
- rim: name
- cda: .patient.name
- argonaut-dq-dstu2: Patient.name
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id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idShort 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 |
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort 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 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 idShort 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 I | 0..1 | string | Element idShort 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
- argonaut-dq-dstu2: Patient.name.family
|
given | S Σ I | 0..* | string | Element idShort description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition 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
- argonaut-dq-dstu2: Patient.name.given
|
prefix | Σ | 0..* | string | There are no (further) constraints on this element Element idShort 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 | Element idShort 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]
- argonaut-dq-dstu2: NA
|
period | Σ I | 0..1 | Period | Element idShort 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
- argonaut-dq-dstu2: NA
|
telecom | Σ I | 0..* | ContactPoint | Element idShort 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
- argonaut-dq-dstu2: NA
|
id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.telecom.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ I | 1..1 | codeBinding | Element idShort 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())
Mappings- rim: n/a
- v2: XTN.3
- rim: ./scheme
- servd: ./ContactPointType
- argonaut-dq-dstu2: NA
|
value | S Σ | 1..1 | string | Element idShort 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
- argonaut-dq-dstu2: NA
|
use | S Σ ?! | 0..1 | codeBinding | Element idShort 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 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
- argonaut-dq-dstu2: NA
|
rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idShort 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 |
period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idShort 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 | 1..1 | codeBinding | Element idShort 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
- argonaut-dq-dstu2: Patient.gender
|
birthDate | S Σ | 0..1 | date | Element idShort 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
- argonaut-dq-dstu2: Patient.birthDate
|
deceased[x] | Σ ?! | 0..1 | | There are no (further) constraints on this element Element idShort 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 | S Σ | 0..* | Address | Element idShort 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
- argonaut-dq-dstu2: Patient.birthDate
|
id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.address.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description home | work | temp | old | billing - purpose of this address Definition The purpose of this address.
Requirements Allows an appropriate address to be chosen from a list of many.
Comments Applications can assume that an address is current unless it explicitly says that it is temporary or old.
Data type code Binding AddressUse (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: XAD.7
- rim: unique(./use)
- servd: ./AddressPurpose
|
type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description postal | physical | both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
Comments The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
Data type code Binding The type of an address (physical / postal).
AddressType (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: XAD.18
- rim: unique(./use)
- vcard: address type parameter
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
Requirements A renderable, unencoded form.
Comments Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples General137 Nowhere Street, Erewhon 9132 Mappings- rim: n/a
- v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
- rim: ./formatted
- vcard: address label parameter
|
line | S Σ | 0..* | string | Element idShort description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples General137 Nowhere Street Mappings- rim: n/a
- v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
- rim: AD.part[parttype = AL]
- vcard: street
- servd: ./StreetAddress (newline delimitted)
- argonaut-dq-dstu2: NA
|
city | S Σ | 0..1 | string | Element idShort description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: XAD.3
- rim: AD.part[parttype = CTY]
- vcard: locality
- servd: ./Jurisdiction
- argonaut-dq-dstu2: NA
|
district | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description District name (aka county) Alternate names County Definition The name of the administrative area (county).
Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: XAD.9
- rim: AD.part[parttype = CNT | CPA]
|
state | S Σ | 0..1 | stringBinding | Element idShort 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).
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data type string Binding Two Letter USPS alphabetic codes.
UspsTwoLetterAlphabeticCodes (extensible)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.4
- rim: AD.part[parttype = STA]
- vcard: region
- servd: ./Region
- argonaut-dq-dstu2: NA
|
postalCode | S Σ | 0..1 | string | Element idPatient.address.postalCode Short description US Zip Codes Alternate names Zip, Zip Code Definition A postal code designating a region defined by the postal service.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim: n/a
- v2: XAD.5
- rim: AD.part[parttype = ZIP]
- vcard: code
- servd: ./PostalIdentificationCode
- argonaut-dq-dstu2: NA
|
country | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted.
Comments ISO 3166 3 letter codes can be used in place of a human readable country name.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.6
- rim: AD.part[parttype = CNT]
- vcard: country
- servd: ./Country
|
period | S Σ I | 0..1 | Period | Element idShort description Time period when address was/is in use Definition Time period when address was/is in use.
Requirements Allows addresses to be placed in historical context.
Comments 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)
Examples General{
"start": "2010-03-23",
"end": "2010-07-01"
} Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: XAD.12 / XAD.13 + XAD.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
- argonaut-dq-dstu2: NA
|
maritalStatus | | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idShort 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 idShort 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 idShort description Image of the patient Definition 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 idShort 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 idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
relationship | | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.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 idShort 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 idShort 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 idShort 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 idShort 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 idPatient.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 idShort 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 | Element idShort 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
- argonaut-dq-dstu2: Patient.communication
|
id | | 0..1 | string | There are no (further) constraints on this element Element idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
language | S | 1..1 | CodeableConceptBinding | Element idPatient.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 LanguageCodesWithLanguageAndOptionallyARegionModifier (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-15, LAN-2
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
- cda: .languageCode
- argonaut-dq-dstu2: Patient.communication.language
|
preferred | | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.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 idPatient.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 idPatient.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 idShort 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 idShort 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 |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idShort 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 |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.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 |
other | Σ I | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element idShort 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 idShort 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
|
{
"resourceType": "StructureDefinition",
"id": "us-core-patient",
"text": {
"status": "generated",
--- We have skipped the narrative for better readability of the resource ---
},
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
"version": "1.0",
"name": "US Core Patient Profile",
"status": "draft",
"date": "2016-08-01",
"publisher": "HL7 US Realm Steering Committee",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://www.healthit.gov"
}
]
}
],
"fhirVersion": "3.1.0",
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"uri": "http://unknown.org/Argonaut DQ DSTU2",
"name": "Argonaut DQ DSTU2"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "cda",
"uri": "http://hl7.org/v3/cda",
"name": "CDA (R2)"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping"
},
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "loinc",
"uri": "http://loinc.org",
"name": "LOINC code for the element"
}
],
"kind": "resource",
"abstract": false,
"type": "Patient",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Patient",
"path": "Patient",
"short": "US Core Patient Profile",
"definition": "The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.",
"alias": [
"SubjectOfCare Client Resident"
],
"min": 0,
"max": "*",
"base": {
"path": "Patient",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
"expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
"xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
"source": "DomainResource"
}
],
"mustSupport": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "Patient[classCode=PAT]"
},
{
"identity": "cda",
"map": "ClinicalDocument.recordTarget.patientRole"
},
{
"identity": "w5",
"map": "administrative.individual"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient"
}
]
},
{
"id": "Patient.id",
"path": "Patient.id",
"short": "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.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"isSummary": true
},
{
"id": "Patient.meta",
"path": "Patient.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"isSummary": true
},
{
"id": "Patient.implicitRules",
"path": "Patient.implicitRules",
"short": "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.",
"comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"isModifier": true,
"isSummary": true
},
{
"id": "Patient.language",
"path": "Patient.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "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).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/languages"
}
}
},
{
"id": "Patient.text",
"path": "Patient.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource, and may 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.",
"comment": "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 in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Patient.contained",
"path": "Patient.contained",
"short": "Contained, inline 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.",
"comment": "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.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.extension",
"path": "Patient.extension",
"slicing": {
"id": "1",
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "Patient.extension:race",
"path": "Patient.extension",
"sliceName": "race",
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.extension:ethnicity",
"path": "Patient.extension",
"sliceName": "ethnicity",
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.extension:birthsex",
"path": "Patient.extension",
"sliceName": "birthsex",
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.modifierExtension",
"path": "Patient.modifierExtension",
"short": "Extensions that cannot be ignored",
"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. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.identifier",
"path": "Patient.identifier",
"short": "An identifier for this patient",
"definition": "An identifier for this patient.",
"requirements": "Patients are almost always assigned specific numerical identifiers.",
"min": 1,
"max": "*",
"base": {
"path": "Patient.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": ".id"
},
{
"identity": "w5",
"map": "id"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier"
}
]
},
{
"id": "Patient.identifier.id",
"path": "Patient.identifier.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier.extension",
"path": "Patient.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier.use",
"path": "Patient.identifier.use",
"short": "usual | official | temp | secondary (If known)",
"definition": "The purpose of this identifier.",
"comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/identifier-use"
}
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier.type",
"path": "Patient.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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. \n\nWhere 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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/identifier-type"
}
},
"mapping": [
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier.system",
"path": "Patient.identifier.system",
"short": "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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier.system"
}
]
},
{
"id": "Patient.identifier.value",
"path": "Patient.identifier.value",
"short": "The value that is unique within the system.",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html).",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier.value"
}
]
},
{
"id": "Patient.identifier.period",
"path": "Patient.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.identifier.assigner",
"path": "Patient.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Patient.active",
"path": "Patient.active",
"short": "Whether this patient's record is in active use",
"definition": "Whether this patient record is in active use.",
"comment": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient\n\nThis element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.",
"requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.active",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"defaultValueBoolean": true,
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "statusCode"
},
{
"identity": "cda",
"map": "n/a"
},
{
"identity": "w5",
"map": "status"
}
]
},
{
"id": "Patient.name",
"path": "Patient.name",
"short": "A name associated with the patient",
"definition": "A name associated with the individual.",
"comment": "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.",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
"min": 1,
"max": "*",
"base": {
"path": "Patient.name",
"min": 0,
"max": "*"
},
"type": [
{
"code": "HumanName"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-5, PID-9"
},
{
"identity": "rim",
"map": "name"
},
{
"identity": "cda",
"map": ".patient.name"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name"
}
]
},
{
"id": "Patient.name.id",
"path": "Patient.name.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.name.extension",
"path": "Patient.name.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.name.use",
"path": "Patient.name.use",
"short": "usual | official | temp | nickname | anonymous | old | maiden",
"definition": "Identifies the purpose for this name.",
"comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
"requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "NameUse"
}
],
"strength": "required",
"description": "The use of a human name",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/name-use"
}
},
"mapping": [
{
"identity": "v2",
"map": "XPN.7, but often indicated by which field contains the name"
},
{
"identity": "rim",
"map": "unique(./use)"
},
{
"identity": "servd",
"map": "./NamePurpose"
}
]
},
{
"id": "Patient.name.text",
"path": "Patient.name.text",
"short": "Text representation of the full name",
"definition": "A full text representation of the name.",
"comment": "Can provide both a text representation and structured parts.",
"requirements": "A renderable, unencoded form.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "implied by XPN.11"
},
{
"identity": "rim",
"map": "./formatted"
}
]
},
{
"id": "Patient.name.family",
"path": "Patient.name.family",
"short": "Family name (often called '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.",
"comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
"alias": [
"surname"
],
"min": 1,
"max": "1",
"base": {
"path": "HumanName.family",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.1/FN.1"
},
{
"identity": "rim",
"map": "./part[partType = FAM]"
},
{
"identity": "servd",
"map": "./FamilyName"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name.family"
}
]
},
{
"id": "Patient.name.given",
"path": "Patient.name.given",
"short": "Given names (not always 'first'). Includes middle names",
"definition": "Given name.",
"comment": "If only initials are recorded, they may be used in place of the full name. Not called \"first name\" since given names do not always come first.",
"alias": [
"first name",
"middle name"
],
"min": 1,
"max": "*",
"base": {
"path": "HumanName.given",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Given Names appear in the correct order for presenting the name",
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.2 + XPN.3"
},
{
"identity": "rim",
"map": "./part[partType = GIV]"
},
{
"identity": "servd",
"map": "./GivenNames"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name.given"
}
]
},
{
"id": "Patient.name.prefix",
"path": "Patient.name.prefix",
"short": "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.",
"min": 0,
"max": "*",
"base": {
"path": "HumanName.prefix",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Prefixes appear in the correct order for presenting the name",
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.5"
},
{
"identity": "rim",
"map": "./part[partType = PFX]"
},
{
"identity": "servd",
"map": "./TitleCode"
}
]
},
{
"id": "Patient.name.suffix",
"path": "Patient.name.suffix",
"short": "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.",
"min": 0,
"max": "*",
"base": {
"path": "HumanName.suffix",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Suffixes appear in the correct order for presenting the name",
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN/4"
},
{
"identity": "rim",
"map": "./part[partType = SFX]"
}
]
},
{
"id": "Patient.name.period",
"path": "Patient.name.period",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.13 + XPN.14"
},
{
"identity": "rim",
"map": "./usablePeriod[type=\"IVL<TS>\"]"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.telecom",
"path": "Patient.telecom",
"short": "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.",
"comment": "A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.telecom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "ContactPoint"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-13, PID-14, PID-40"
},
{
"identity": "rim",
"map": "telecom"
},
{
"identity": "cda",
"map": ".telecom"
}
]
},
{
"id": "Patient.gender",
"path": "Patient.gender",
"short": "male | female | other | unknown",
"definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.",
"comment": "The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, 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, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error.",
"requirements": "Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.gender",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
"strength": "required",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
}
},
"mapping": [
{
"identity": "v2",
"map": "PID-8"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
},
{
"identity": "cda",
"map": ".patient.administrativeGenderCode"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.gender"
}
]
},
{
"id": "Patient.birthDate",
"path": "Patient.birthDate",
"short": "The date of birth for the individual",
"definition": "The date of birth for the individual.",
"comment": "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 maternaty/infant care systems).",
"requirements": "Age of the individual drives many clinical processes.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.birthDate",
"min": 0,
"max": "1"
},
"type": [
{
"code": "date"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-7"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"
},
{
"identity": "cda",
"map": ".patient.birthTime"
},
{
"identity": "loinc",
"map": "21112-8"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.birthDate"
}
]
},
{
"id": "Patient.deceased[x]",
"path": "Patient.deceased[x]",
"short": "Indicates if the individual is deceased or not",
"definition": "Indicates if the individual is deceased or not.",
"comment": "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.\n\nThis element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.deceased[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
},
{
"code": "dateTime"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-30 (bool) and PID-29 (datetime)"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.address",
"path": "Patient.address",
"short": "Addresses for the individual",
"definition": "Addresses for the individual.",
"comment": "Patient may have multiple addresses with different uses or applicable periods.",
"requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.address",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Address"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-11"
},
{
"identity": "rim",
"map": "addr"
},
{
"identity": "cda",
"map": ".addr"
}
]
},
{
"id": "Patient.maritalStatus",
"path": "Patient.maritalStatus",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.maritalStatus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MaritalStatus"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "The domestic partnership status of a person.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/marital-status"
}
},
"mapping": [
{
"identity": "v2",
"map": "PID-16"
},
{
"identity": "rim",
"map": "player[classCode=PSN]/maritalStatusCode"
},
{
"identity": "cda",
"map": ".patient.maritalStatusCode"
}
]
},
{
"id": "Patient.multipleBirth[x]",
"path": "Patient.multipleBirth[x]",
"short": "Whether patient is part of a multiple birth",
"definition": "Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).",
"comment": "Where the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
"requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.multipleBirth[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
},
{
"code": "integer"
}
],
"mapping": [
{
"identity": "v2",
"map": "PID-24 (bool), PID-25 (integer)"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.photo",
"path": "Patient.photo",
"short": "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.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.photo",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Attachment"
}
],
"mapping": [
{
"identity": "v2",
"map": "OBX-5 - needs a profile"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Contact"
}
],
"path": "Patient.contact",
"short": "A contact party (e.g. guardian, partner, friend) for the patient",
"definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
"comment": "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.",
"requirements": "Need to track people you can contact about the patient.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
},
{
"key": "pat-1",
"severity": "error",
"human": "SHALL at least contain a contact's details or a reference to an organization",
"expression": "name.exists() or telecom.exists() or address.exists() or organization.exists()",
"xpath": "exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"
}
],
"mapping": [
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.id",
"path": "Patient.contact.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.extension",
"path": "Patient.contact.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.modifierExtension",
"path": "Patient.contact.modifierExtension",
"short": "Extensions that cannot be ignored",
"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 that contains it. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.contact.relationship",
"path": "Patient.contact.relationship",
"short": "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.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact.relationship",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactRelationship"
}
],
"strength": "extensible",
"description": "The nature of the relationship between a patient and a contact person for that patient.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/v2-0131"
}
},
"mapping": [
{
"identity": "v2",
"map": "NK1-7, NK1-3"
},
{
"identity": "rim",
"map": "code"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.name",
"path": "Patient.contact.name",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.name",
"min": 0,
"max": "1"
},
"type": [
{
"code": "HumanName"
}
],
"mapping": [
{
"identity": "v2",
"map": "NK1-2"
},
{
"identity": "rim",
"map": "name"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.telecom",
"path": "Patient.contact.telecom",
"short": "A contact detail for the person",
"definition": "A contact detail for the person, e.g. a telephone number or an email address.",
"comment": "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.",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact.telecom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "ContactPoint"
}
],
"mapping": [
{
"identity": "v2",
"map": "NK1-5, NK1-6, NK1-40"
},
{
"identity": "rim",
"map": "telecom"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.address",
"path": "Patient.contact.address",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.address",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Address"
}
],
"mapping": [
{
"identity": "v2",
"map": "NK1-4"
},
{
"identity": "rim",
"map": "addr"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.gender",
"path": "Patient.contact.gender",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.gender",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdministrativeGender"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "required",
"description": "The gender of a person used for administrative purposes.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
}
},
"mapping": [
{
"identity": "v2",
"map": "NK1-15"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.organization",
"path": "Patient.contact.organization",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.organization",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"condition": [
"pat-1"
],
"mapping": [
{
"identity": "v2",
"map": "NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"
},
{
"identity": "rim",
"map": "scoper"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.period",
"path": "Patient.contact.period",
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"mapping": [
{
"identity": "rim",
"map": "effectiveTime"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.animal",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Animal"
}
],
"path": "Patient.animal",
"short": "This patient is known to be an animal (non-human)",
"definition": "This patient is known to be an animal.",
"comment": "The animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).",
"requirements": "Many clinical systems are extended to care for animal patients as well as human.",
"min": 0,
"max": "0",
"base": {
"path": "Patient.animal",
"min": 0,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"mustSupport": false,
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "player[classCode=ANM]"
},
{
"identity": "cda",
"map": "n/a"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.animal"
}
]
},
{
"id": "Patient.animal.id",
"path": "Patient.animal.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.animal.extension",
"path": "Patient.animal.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.animal.modifierExtension",
"path": "Patient.animal.modifierExtension",
"short": "Extensions that cannot be ignored",
"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 that contains it. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.animal.species",
"path": "Patient.animal.species",
"short": "E.g. Dog, Cow",
"definition": "Identifies the high level taxonomic categorization of the kind of animal.",
"comment": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
"requirements": "Need to know what kind of animal.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.animal.species",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AnimalSpecies"
}
],
"strength": "example",
"description": "The species of an animal.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/animal-species"
}
},
"mapping": [
{
"identity": "v2",
"map": "PID-35"
},
{
"identity": "rim",
"map": "code"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.animal.breed",
"path": "Patient.animal.breed",
"short": "E.g. Poodle, Angus",
"definition": "Identifies the detailed categorization of the kind of animal.",
"comment": "Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
"requirements": "May need to know the specific kind within the species.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.animal.breed",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AnimalBreed"
}
],
"strength": "example",
"description": "The breed of an animal.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/animal-breeds"
}
},
"mapping": [
{
"identity": "v2",
"map": "PID-37"
},
{
"identity": "rim",
"map": "playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.animal.genderStatus",
"path": "Patient.animal.genderStatus",
"short": "E.g. Neutered, Intact",
"definition": "Indicates the current state of the animal's reproductive organs.",
"requirements": "Gender status can affect housing and animal behavior.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.animal.genderStatus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AnimalGenderStatus"
}
],
"strength": "example",
"description": "The state of the animal's reproductive organs.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/animal-genderstatus"
}
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "genderStatusCode"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.communication",
"path": "Patient.communication",
"short": "A list of Languages which may be used to communicate with the patient about his or her health",
"definition": "Languages which may be used to communicate with the patient about his or her health.",
"comment": "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.",
"requirements": "If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.communication",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"mustSupport": true,
"mapping": [
{
"identity": "rim",
"map": "LanguageCommunication"
},
{
"identity": "cda",
"map": "patient.languageCommunication"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.communication"
}
]
},
{
"id": "Patient.communication.id",
"path": "Patient.communication.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.communication.extension",
"path": "Patient.communication.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.communication.modifierExtension",
"path": "Patient.communication.modifierExtension",
"short": "Extensions that cannot be ignored",
"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 that contains it. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.communication.language",
"path": "Patient.communication.language",
"short": "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.",
"comment": "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.",
"requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.communication.language",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"mustSupport": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
}
}
],
"strength": "extensible",
"valueSetReference": {
"reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
}
},
"mapping": [
{
"identity": "v2",
"map": "PID-15, LAN-2"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"
},
{
"identity": "cda",
"map": ".languageCode"
},
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.communication.language"
}
]
},
{
"id": "Patient.communication.preferred",
"path": "Patient.communication.preferred",
"short": "Language preference indicator",
"definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
"comment": "This language is specifically identified for communicating healthcare information.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.communication.preferred",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"mapping": [
{
"identity": "v2",
"map": "PID-15"
},
{
"identity": "rim",
"map": "preferenceInd"
},
{
"identity": "cda",
"map": ".preferenceInd"
}
]
},
{
"id": "Patient.generalPractitioner",
"path": "Patient.generalPractitioner",
"short": "Patient's nominated primary care provider",
"definition": "Patient's nominated care provider.",
"comment": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt 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.",
"alias": [
"careProvider"
],
"min": 0,
"max": "*",
"base": {
"path": "Patient.generalPractitioner",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
}
],
"mapping": [
{
"identity": "v2",
"map": "PD1-4"
},
{
"identity": "rim",
"map": "subjectOf.CareEvent.performer.AssignedEntity"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.managingOrganization",
"path": "Patient.managingOrganization",
"short": "Organization that is the custodian of the patient record",
"definition": "Organization that is the custodian of the patient record.",
"comment": "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).",
"requirements": "Need to know who recognizes this patient record, manages and updates it.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.managingOrganization",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "scoper"
},
{
"identity": "cda",
"map": ".providerOrganization"
}
]
},
{
"id": "Patient.link",
"path": "Patient.link",
"short": "Link to another patient resource that concerns the same actual person",
"definition": "Link to another patient resource that concerns the same actual patient.",
"comment": "There is no assumption that linked patient records have mutual links. \n\nThis element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.",
"requirements": "There are multiple usecases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.link",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "outboundLink"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.link.id",
"path": "Patient.link.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.link.extension",
"path": "Patient.link.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.link.modifierExtension",
"path": "Patient.link.modifierExtension",
"short": "Extensions that cannot be ignored",
"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 that contains it. Usually modifier elements provide negation or qualification. In order 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.",
"comment": "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.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.link.other",
"path": "Patient.link.other",
"short": "The other patient or related person resource that the link refers to",
"definition": "The other patient resource that the link refers to.",
"comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.link.other",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
}
],
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-3, MRG-1"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.link.type",
"path": "Patient.link.type",
"short": "replaced-by | replaces | refer | seealso - type of link",
"definition": "The type of link between this patient resource and another patient resource.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.link.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "LinkType"
}
],
"strength": "required",
"description": "The type of link between this patient resource and another patient resource.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/link-type"
}
},
"mapping": [
{
"identity": "rim",
"map": "typeCode"
},
{
"identity": "cda",
"map": "n/a"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Patient",
"path": "Patient",
"short": "US Core Patient Profile",
"definition": "The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.",
"mustSupport": false,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient"
}
]
},
{
"id": "Patient.extension:race",
"path": "Patient.extension",
"sliceName": "race",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.extension:ethnicity",
"path": "Patient.extension",
"sliceName": "ethnicity",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.extension:birthsex",
"path": "Patient.extension",
"sliceName": "birthsex",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"
}
],
"mustSupport": true,
"isModifier": false,
"binding": {
"strength": "required",
"description": "Code for sex assigned at birth",
"valueSetReference": {
"reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-birthsex"
}
},
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.extension"
}
]
},
{
"id": "Patient.identifier",
"path": "Patient.identifier",
"min": 1,
"max": "*",
"type": [
{
"code": "Identifier"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier"
}
]
},
{
"id": "Patient.identifier.system",
"path": "Patient.identifier.system",
"min": 1,
"max": "1",
"type": [
{
"code": "uri"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier.system"
}
]
},
{
"id": "Patient.identifier.value",
"path": "Patient.identifier.value",
"short": "The value that is unique within the system.",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.identifier.value"
}
]
},
{
"id": "Patient.name",
"path": "Patient.name",
"min": 1,
"max": "*",
"type": [
{
"code": "HumanName"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name"
}
]
},
{
"id": "Patient.name.family",
"path": "Patient.name.family",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name.family"
}
]
},
{
"id": "Patient.name.given",
"path": "Patient.name.given",
"min": 1,
"max": "*",
"type": [
{
"code": "string"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.name.given"
}
]
},
{
"id": "Patient.gender",
"path": "Patient.gender",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"mustSupport": true,
"isModifier": false,
"binding": {
"strength": "required",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
}
},
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.gender"
}
]
},
{
"id": "Patient.birthDate",
"path": "Patient.birthDate",
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"max": "1",
"type": [
{
"code": "date"
}
],
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.birthDate"
}
]
},
{
"id": "Patient.animal",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Animal"
}
],
"path": "Patient.animal",
"min": 0,
"max": "0",
"type": [
{
"code": "BackboneElement"
}
],
"mustSupport": false,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.animal"
}
]
},
{
"id": "Patient.communication",
"path": "Patient.communication",
"min": 0,
"max": "*",
"mustSupport": true,
"isModifier": false,
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.communication"
}
]
},
{
"id": "Patient.communication.language",
"path": "Patient.communication.language",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"mustSupport": true,
"isModifier": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
}
}
],
"strength": "extensible",
"valueSetReference": {
"reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
}
},
"mapping": [
{
"identity": "argonaut-dq-dstu2",
"map": "Patient.communication.language"
}
]
}
]
}
}