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Patient I Patient There are no (further) constraints on this elementElement idShort descriptionPatient
Information about an individual or animal receiving health care services
Alternate namesSubjectOfCare Client Resident
DefinitionData type ConstraintsDemographics and other administrative information about an individual or animal receiving care or other health-related services.
Mappings- 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()
- maz-1: follow my rule
address.exists() or name.exists()
- rim: Entity. Role, or Act
- rim: Patient[classCode=PAT]
- cda: ClinicalDocument.recordTarget.patientRole
id Σ 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.id
Logical id of this artifact
DefinitionCommentsThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Data typeThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta Σ 0..1 Meta There are no (further) constraints on this elementElement idShort descriptionPatient.meta
Metadata about the resource
DefinitionData type ConstraintsThe 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
implicitRules Σ ?! 0..1 uri There are no (further) constraints on this elementElement idShort descriptionPatient.implicitRules
A set of rules under which this content was created
DefinitionCommentsA 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.
Data type ConstraintsAsserting 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
language 0..1 codeBinding There are no (further) constraints on this elementElement idShort descriptionPatient.language
Language of the resource content
DefinitionCommentsThe base language in which the resource is written.
Data type BindingLanguage 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).
CommonLanguages (preferred)ConstraintsA human language.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
text 0..1 Narrative There are no (further) constraints on this elementElement idShort descriptionPatient.text
Text summary of the resource, for human interpretation
Alternate namesnarrative, html, xhtml, display
DefinitionCommentsA 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.
Data type ConstraintsContained 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
- rim: Act.text?
contained 0..* Resource There are no (further) constraints on this elementElement idShort descriptionPatient.contained
Contained, inline Resources
Alternate namesinline resources, anonymous resources, contained resources
DefinitionCommentsThese 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.
Data type MappingsThis 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.
- rim: Entity. Role, or Act
- rim: N/A
extension I 0..* Extension Element id Short descriptionPatient.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
indigenous-status I 0..1 Extension(Coding)Binding There are no (further) constraints on this elementElement idShort descriptionPatient.extension:indigenous-status
Indigenous status
Alternate namesextensions, user content
DefinitionCommentsindigenous status
Data type Extension URLSee Australian Institute of Health and Welfare (AIHW) Person—Indigenous status (ID 602543) for further information.
http://hl7.org.au/fhir/StructureDefinition/indigenous-status
BindingAustralianIndigenousStatus (required)Constraintsindigenous-status
Mappings- 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()
- rim: n/a
- rim: N/A
occupation I 0..* Extension(Complex)Binding There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation
Occupation types
Alternate namesextensions, user content
DefinitionCommentsPatients' occupation types
Data typeThere 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.
Extension(Complex)
Extension URLhttps://alcidion.com/miya/StructureDefinition/Occupation
Bindinghttp://loinc.org/85658-4 (required)
ConstraintsMappings- 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()
- rim: n/a
- rim: N/A
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension Element id Short descriptionPatient.extension:occupation.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
occCode I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occCode
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type ConstraintsThere 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.
Mappings- 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()
- rim: n/a
- rim: N/A
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occCode.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occCode.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
url 1..1 uriFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occCode.url
identifies the meaning of the extension
DefinitionCommentsSource of the definition for the extension code - a logical name or a URL.
Data type Fixed valueThe 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.
MappingsoccCode
- rim: N/A
value[x] 0..1 Binding Element id Short descriptionPatient.extension:occupation.extension:occCode.value[x]
Value of extension
DefinitionBindingValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
http://www.alpha-hospital.alp/occupations (required)ConstraintsOccupations
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
valueCodeableConcept CodeableConcept There are no (further) constraints on this elementData typeoccPeriod I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occPeriod
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type ConstraintsThere 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.
Mappings- 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()
- rim: n/a
- rim: N/A
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occPeriod.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occPeriod.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
url 1..1 uriFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occPeriod.url
identifies the meaning of the extension
DefinitionCommentsSource of the definition for the extension code - a logical name or a URL.
Data type Fixed valueThe 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.
MappingsoccPeriod
- rim: N/A
value[x] 0..1 There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.extension:occPeriod.value[x]
Value of extension
DefinitionConstraintsValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
valuePeriod Period There are no (further) constraints on this elementData typeurl 1..1 uriFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.url
identifies the meaning of the extension
DefinitionCommentsSource of the definition for the extension code - a logical name or a URL.
Data type Fixed valueThe 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.
Mappingshttps://alcidion.com/miya/StructureDefinition/Occupation
- rim: N/A
value[x] 0..0 There are no (further) constraints on this elementElement idShort descriptionPatient.extension:occupation.value[x]
Value of extension
DefinitionConstraintsValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
modifierExtension ?! I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.modifierExtension
Extensions that cannot be ignored
Alternate namesextensions, user content
DefinitionRequirementsMay 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).
CommentsModifier 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
identifier Σ 1..1 Identifier Element id Short descriptionPatient.identifier
An identifier for this patient
DefinitionRequirementsAn identifier for this patient.
Data type Sliced:Patients are almost always assigned specific numerical identifiers.
Unordered, Open, by system(Value), assigner.type(Value)
ConstraintsMappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
hospitalId Σ 0..1 IdentifierFixed Value Element id Short descriptionPatient.identifier:hospitalId
An identifier for this patient
DefinitionRequirementsAn identifier for this patient.
Data type ConstraintsPatients are almost always assigned specific numerical identifiers.
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings{ "use": "official", "system": "http://alcidion.com/ids" }
- 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
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
use Σ ?! 0..1 codeBindingFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.use
usual | official | temp | secondary | old (If known)
DefinitionRequirementsThe purpose of this identifier.
CommentsAllows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Data type BindingApplications can assume that an identifier is permanent unless it explicitly says that it is temporary.
IdentifierUse (required)ConstraintsIdentifies the purpose for this identifier, if known .
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappingsofficial
- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
type Σ 0..1 CodeableConceptBinding There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.type
Description of identifier
DefinitionRequirementsA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
CommentsAllows users to make use of identifiers when the identifier system is not known.
Data type BindingThis 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.
Identifier Type Codes (extensible)ConstraintsA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
system S Σ 1..1 uriFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.system
The namespace for the identifier value
DefinitionRequirementsEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
CommentsThere 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.
Data type ConstraintsIdentifier.system is always case sensitive.
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappingshttp://alcidion.com/ids
- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
value S Σ 1..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.value
The value that is unique
DefinitionCommentsThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Data type ConstraintsIf 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.
Examples- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
General123456
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
period Σ I 0..1 Period There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.period
Time period when id is/was valid for use
DefinitionCommentsTime period during which identifier is/was valid for use.
Data type ConstraintsA 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.
Mappings- 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)
- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
assigner Σ I 1..1 Reference(Organization) There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:hospitalId.assigner
Organization that issued id (may be just text)
DefinitionCommentsOrganization that issued/manages the identifier.
Data type ConstraintsThe Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Mappings- 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'))
- 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
officialId Σ 0..1 IdentifierFixed Value Element id Short descriptionPatient.identifier:officialId
An identifier for this patient
DefinitionRequirementsAn identifier for this patient.
Data type ConstraintsPatients are almost always assigned specific numerical identifiers.
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings{ "use": "official", "system": "http://ihi.au/id" }
- 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
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
use Σ ?! 0..1 codeBindingFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.use
usual | official | temp | secondary | old (If known)
DefinitionRequirementsThe purpose of this identifier.
CommentsAllows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Data type BindingApplications can assume that an identifier is permanent unless it explicitly says that it is temporary.
IdentifierUse (required)ConstraintsIdentifies the purpose for this identifier, if known .
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappingsofficial
- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
type Σ 0..1 CodeableConceptBinding There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.type
Description of identifier
DefinitionRequirementsA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
CommentsAllows users to make use of identifiers when the identifier system is not known.
Data type BindingThis 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.
Identifier Type Codes (extensible)ConstraintsA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
system S Σ 1..1 uriFixed Value There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.system
The namespace for the identifier value
DefinitionRequirementsEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
CommentsThere 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.
Data type ConstraintsIdentifier.system is always case sensitive.
Fixed value- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappingshttp://ihi.au/id
- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
value S Σ 1..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.value
The value that is unique
DefinitionCommentsThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Data type ConstraintsIf 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.
Examples- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
General123456
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
period Σ I 0..1 Period There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.period
Time period when id is/was valid for use
DefinitionCommentsTime period during which identifier is/was valid for use.
Data type ConstraintsA 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.
Mappings- 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)
- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
assigner Σ I 0..1 Reference(Organization) There are no (further) constraints on this elementElement idShort descriptionPatient.identifier:officialId.assigner
Organization that issued id (may be just text)
DefinitionCommentsOrganization that issued/manages the identifier.
Data type ConstraintsThe Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Mappings- 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'))
- 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
active Σ ?! 0..1 boolean There are no (further) constraints on this elementElement idShort descriptionPatient.active
Whether this patient's record is in active use
DefinitionRequirementsWhether 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.
CommentsNeed to be able to mark a patient record as not to be used because it was created in error.
Meaning when missingIf a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Data type ConstraintsThis resource is generally assumed to be active if no value is provided for the active element
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- w5: FiveWs.status
- rim: statusCode
- cda: n/a
name Σ 0..* MyHumanName There are no (further) constraints on this elementElement idShort descriptionPatient.name
Name of a human - parts and usage
DefinitionRequirementsA human's name with the ability to identify parts and usage.
CommentsNeed to be able to track the patient by multiple names. Examples are your official name and a partner name.
Data type ConstraintsNames 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN
- rim: EN (actually, PN)
- servd: ProviderName
- v2: PID-5, PID-9
- rim: name
- cda: .patient.name
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.name.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.name.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
use Σ ?! I 0..1 codeBinding There are no (further) constraints on this elementElement idShort descriptionPatient.name.use
usual | official | temp | nickname | anonymous | old | maiden
DefinitionRequirementsIdentifies the purpose for this name.
CommentsAllows the appropriate name for a particular context of use to be selected from among a set of names.
Data type BindingApplications can assume that a name is current unless it explicitly says that it is temporary or old.
NameUse (required)ConstraintsThe use of a human name.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.name.text
Text representation of the full name
DefinitionRequirementsSpecifies 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.
CommentsA renderable, unencoded form.
Data type ConstraintsCan 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: implied by XPN.11
- rim: ./formatted
family S Σ 1..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.name.family
Family name (often called 'Surname')
Alternate namessurname
DefinitionCommentsThe 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.
Data type ConstraintsFamily Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN.1/FN.1
- rim: ./part[partType = FAM]
- servd: ./FamilyName
given S Σ 1..3 string There are no (further) constraints on this elementElement idShort descriptionPatient.name.given
Given names (not always 'first'). Includes middle names
Alternate namesfirst name, middle name
DefinitionCommentsGiven name.
Data type ConstraintsIf 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN.2 + XPN.3
- rim: ./part[partType = GIV]
- servd: ./GivenNames
prefix Σ 0..* string There are no (further) constraints on this elementElement idShort descriptionPatient.name.prefix
Parts that come before the name
DefinitionCommentsPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.
Data type ConstraintsNote that FHIR strings SHALL NOT exceed 1MB in size
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN.5
- rim: ./part[partType = PFX]
- servd: ./TitleCode
suffix Σ 0..* string There are no (further) constraints on this elementElement idShort descriptionPatient.name.suffix
Parts that come after the name
DefinitionCommentsPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.
Data type ConstraintsNote that FHIR strings SHALL NOT exceed 1MB in size
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN/4
- rim: ./part[partType = SFX]
period Σ I 0..1 Period There are no (further) constraints on this elementElement idShort descriptionPatient.name.period
Time period when name was/is in use
DefinitionRequirementsIndicates the period of time when this name was valid for the named person.
CommentsAllows names to be placed in historical context.
Data type ConstraintsA 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.
Mappings- 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)
- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: XPN.13 + XPN.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
telecom Σ I 0..* ContactPoint There are no (further) constraints on this elementElement idShort descriptionPatient.telecom
A contact detail for the individual
DefinitionRequirementsA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
CommentsPeople have (primary) ways to contact them in some way such as phone, email.
Data type ConstraintsA 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).
Mappings- 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()
- rim: n/a
- v2: XTN
- rim: TEL
- servd: ContactPoint
- v2: PID-13, PID-14, PID-40
- rim: telecom
- cda: .telecom
gender Σ 0..1 codeBinding There are no (further) constraints on this elementElement idShort descriptionPatient.gender
male | female | other | unknown
DefinitionRequirementsAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
CommentsNeeded for identification of the individual, in combination with (at least) name and birth date.
Data type BindingThe 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.
AdministrativeGender (required)ConstraintsThe gender of a person used for administrative purposes.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-8
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- cda: .patient.administrativeGenderCode
birthDate Σ 1..1 date There are no (further) constraints on this elementElement idShort descriptionPatient.birthDate
The date of birth for the individual
DefinitionRequirementsThe date of birth for the individual.
CommentsAge of the individual drives many clinical processes.
Data type ConstraintsAt 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).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-7
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
- cda: .patient.birthTime
- loinc: 21112-8
deceased[x] Σ ?! 0..1 There are no (further) constraints on this elementElement idShort descriptionPatient.deceased[x]
Indicates if the individual is deceased or not
DefinitionRequirementsIndicates if the individual is deceased or not.
CommentsThe 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.
ConstraintsIf 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementData typedeceasedDateTime dateTime There are no (further) constraints on this elementData typeaddress Σ 0..* MyAddress There are no (further) constraints on this elementElement idShort descriptionPatient.address
An address expressed using postal conventions (as opposed to GPS or other location definition formats)
DefinitionRequirementsAn address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.
CommentsMay need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Data type ConstraintsNote: 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).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XAD
- rim: AD
- servd: Address
- v2: PID-11
- rim: addr
- cda: .addr
maritalStatus 0..1 CodeableConceptBinding There are no (further) constraints on this elementElement idShort descriptionPatient.maritalStatus
Marital (civil) status of a patient
DefinitionRequirementsThis field contains a patient's most recent marital (civil) status.
CommentsMost, if not all systems capture it.
Data type BindingNot 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.
Marital Status Codes (extensible)ConstraintsThe domestic partnership status of a person.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.multipleBirth[x]
Whether patient is part of a multiple birth
DefinitionRequirementsIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
CommentsFor disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
ConstraintsWhere 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).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementData typemultipleBirthInteger integer There are no (further) constraints on this elementData typephoto I 0..* Attachment There are no (further) constraints on this elementElement idShort descriptionPatient.photo
Image of the patient
DefinitionRequirementsImage of the patient.
CommentsMany EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Data type ConstraintsGuidelines:
- Use id photos, not clinical photos.
- Limit dimensions to thumbnail.
- Keep byte count low to ease resource updates.
Mappings- 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()
- 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 elementElement idShort descriptionPatient.contact
A contact party (e.g. guardian, partner, friend) for the patient
DefinitionRequirementsA contact party (e.g. guardian, partner, friend) for the patient.
CommentsNeed to track people you can contact about the patient.
Data type ConstraintsContact 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.
Mappings- 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()
- 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 elementElement idShort descriptionPatient.contact.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.contact.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
modifierExtension Σ ?! I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.contact.modifierExtension
Extensions that cannot be ignored even if unrecognized
Alternate namesextensions, user content, modifiers
DefinitionRequirementsMay 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).
CommentsModifier 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.
Data type ConstraintsThere 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.
Mappings- 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()
- rim: n/a
- rim: N/A
relationship 0..* CodeableConceptBinding There are no (further) constraints on this elementElement idShort descriptionPatient.contact.relationship
The kind of relationship
DefinitionRequirementsThe nature of the relationship between the patient and the contact person.
CommentsUsed to determine which contact person is the most relevant to approach, depending on circumstances.
Data type BindingNot 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.
PatientContactRelationship (extensible)ConstraintsThe nature of the relationship between a patient and a contact person for that patient.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.contact.name
A name associated with the contact person
DefinitionRequirementsA name associated with the contact person.
CommentsContact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Data type ConstraintsNames 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.contact.telecom
A contact detail for the person
DefinitionRequirementsA contact detail for the person, e.g. a telephone number or an email address.
CommentsPeople have (primary) ways to contact them in some way such as phone, email.
Data type ConstraintsContact 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.
Mappings- 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()
- 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 elementElement idShort descriptionPatient.contact.address
Address for the contact person
DefinitionRequirementsAddress for the contact person.
CommentsNeed to keep track where the contact person can be contacted per postal mail or visited.
Data type ConstraintsNote: 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).
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.contact.gender
male | female | other | unknown
DefinitionRequirementsAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
CommentsNeeded to address the person correctly.
Data type BindingNote that FHIR strings SHALL NOT exceed 1MB in size
AdministrativeGender (required)ConstraintsThe gender of a person used for administrative purposes.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 elementElement idShort descriptionPatient.contact.organization
Organization that is associated with the contact
DefinitionRequirementsOrganization on behalf of which the contact is acting or for which the contact is working.
CommentsFor guardians or business related contacts, the organization is relevant.
Data type ConstraintsReferences 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.
Mappings- 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'))
- 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 elementElement idShort descriptionPatient.contact.period
The period during which this contact person or organization is valid to be contacted relating to this patient
DefinitionCommentsThe period during which this contact person or organization is valid to be contacted relating to this patient.
Data type ConstraintsA 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.
Mappings- 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)
- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- rim: effectiveTime
- cda: n/a
communication 0..* BackboneElement There are no (further) constraints on this elementElement idShort descriptionPatient.communication
A language which may be used to communicate with the patient about his or her health
DefinitionRequirementsA language which may be used to communicate with the patient about his or her health.
CommentsIf 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.
Data type ConstraintsIf 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.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: LanguageCommunication
- cda: patient.languageCommunication
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.communication.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.communication.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
modifierExtension Σ ?! I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.communication.modifierExtension
Extensions that cannot be ignored even if unrecognized
Alternate namesextensions, user content, modifiers
DefinitionRequirementsMay 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).
CommentsModifier 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.
Data type ConstraintsThere 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.
Mappings- 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()
- rim: n/a
- rim: N/A
language 1..1 CodeableConceptBinding There are no (further) constraints on this elementElement idShort descriptionPatient.communication.language
The language which can be used to communicate with the patient about his or her health
DefinitionRequirementsThe 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.
CommentsMost systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Data type BindingThe 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.
CommonLanguages (preferred)ConstraintsA human language.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: PID-15, LAN-2
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
- cda: .languageCode
preferred 0..1 boolean There are no (further) constraints on this elementElement idShort descriptionPatient.communication.preferred
Language preference indicator
DefinitionRequirementsIndicates whether or not the patient prefers this language (over other languages he masters up a certain level).
CommentsPeople 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.
Data type ConstraintsThis language is specifically identified for communicating healthcare information.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-15
- rim: preferenceInd
- cda: .preferenceInd
generalPractitioner I 0..* Reference(Organization | Practitioner | PractitionerRole) There are no (further) constraints on this elementElement idShort descriptionPatient.generalPractitioner
Patient's nominated primary care provider
Alternate namescareProvider
DefinitionCommentsPatient's nominated care provider.
Data typeThis 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.
Reference(Organization | Practitioner | PractitionerRole)
ConstraintsMappings- 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'))
- 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 elementElement idShort descriptionPatient.managingOrganization
Organization that is the custodian of the patient record
DefinitionRequirementsOrganization that is the custodian of the patient record.
CommentsNeed to know who recognizes this patient record, manages and updates it.
Data type ConstraintsThere 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).
Mappings- 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'))
- 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 elementElement idShort descriptionPatient.link
Link to another patient resource that concerns the same actual person
DefinitionRequirementsLink to another patient resource that concerns the same actual patient.
CommentsThere 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.
Data type ConstraintsThere is no assumption that linked patient records have mutual links.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: outboundLink
- cda: n/a
id 0..1 string There are no (further) constraints on this elementElement idShort descriptionPatient.link.id
Unique id for inter-element referencing
DefinitionData type MappingsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
- rim: n/a
extension I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.link.extension
Additional content defined by implementations
Alternate namesextensions, user content
DefinitionCommentsMay 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.
Data type Sliced: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.
Unordered, Open, by url(Value)
Extensions are always sliced by (at least) urlConstraintsMappings- 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()
- rim: n/a
- rim: N/A
modifierExtension Σ ?! I 0..* Extension There are no (further) constraints on this elementElement idShort descriptionPatient.link.modifierExtension
Extensions that cannot be ignored even if unrecognized
Alternate namesextensions, user content, modifiers
DefinitionRequirementsMay 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).
CommentsModifier 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.
Data type ConstraintsThere 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.
Mappings- 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()
- rim: n/a
- rim: N/A
other Σ I 1..1 Reference(Patient | RelatedPerson) There are no (further) constraints on this elementElement idShort descriptionPatient.link.other
The other patient or related person resource that the link refers to
DefinitionCommentsThe other patient resource that the link refers to.
Data typeReferencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Reference(Patient | RelatedPerson)
ConstraintsMappings- 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'))
- 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 elementElement idShort descriptionPatient.link.type
replaced-by | replaces | refer | seealso
DefinitionCommentsThe type of link between this patient resource and another patient resource.
Data type BindingNote that FHIR strings SHALL NOT exceed 1MB in size
LinkType (required)ConstraintsThe type of link between this patient resource and another patient resource.
Mappings- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: typeCode
- cda: n/a
- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources