Resource Profile: MY Core Organization Profile

Defining URL:	http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
Version:	4.0.0
Name:	MYCoreOrganizationProfile
Title:	MY Core Organization Profile
Status:	Active as of 2022-01-01
Definition:
Defines basic constraints and extensions on the Organization resource for use	with other MY Core resources
Publisher:	HL7 International - MY Realm Steering Committee
Copyright:	Used by permission of HL7 International, all rights reserved Creative Commons License
Source Resource:	XML / JSON / Turtle

The official URL for this profile is:

http://hl7.org/fhir/us/core/StructureDefinition/my-core-organization

This profile sets minimum expectations for the Organization resource to searching for and fetching a Organization associated with a patient or provider. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core-Organization profile:

Query by organization name or NPI

Mandatory and Must Support Data Elements

Example Usage Scenarios:

The following are example usage scenarios for the US Core-Organization profile:

Query by organization name or NPI Mandatory and Must Support Data Elements The following data-elements must always be present (Mandatory definition]) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Organization must have:

A status of the organization
A name
Each Organization must support:

An identifier SHALL support National Provider Identifier (NPI) for organizations SHOULD support Clinical Laboratory Improvement Amendments (CLIA) for laboratories. A list of contact information An address Profile specific implementation guidance:

none

Example

Organization-acme-lab

Organization-with-EndPoint

Formal Views of Profile Content

Resource overview

Almost all overview tabs of any resource can be rendered in your Implementation Guide. StructureDefinitions have their own tree statement for this, other resources use the render statement.

StructureDefinition

You can define the StructureDefinition to be rendered by Canonical or point to a specific File in your project or on Simplifier.net. See the Intellisense page on how you can switch the autocomplete to support you in either.

For the File example the us-core-patient resource in the demo project is used. You can find the resource on https://simplifier.net/demo/us-core-patient-2. Notice that the path in the URL is exactly the same as the placeholder.

For the Canonical example we'll use the FHIR base patient.

Differential

Example based on file urlkey:

Patient	I		Patient	Element id Patient Short description US Core Patient Profile 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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.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 `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole w5: administrative.individual argonaut-dq-dstu2: Patient
id	Σ	0..1	id	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may 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() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and 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. 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 in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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. 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() \| (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
race	S I	0..1	Extension	Element id Patient.extension:race Short 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 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() \| (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
ethnicity	S I	0..1	Extension	Element id Patient.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 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() \| (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
birthsex	S I	0..1	ExtensionBinding	Element id Patient.extension:birthsex Short description Optional Extensions Element Alternate names extensions, user content Definition A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC). 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 Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding Code for sex assigned at birth ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	S Σ	1..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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 v2: PID-3 rim: id cda: .id w5: id argonaut-dq-dstu2: Patient.identifier
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary (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 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. Data type code Binding Identifies the purpose for this identifier, if known . ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings 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 element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
system	S Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType argonaut-dq-dstu2: Patient.identifier.system
value	S Σ	1..1	string	Element id Patient.identifier.value Short 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 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
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments 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 This 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a rim: statusCode cda: n/a w5: status
name	S Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` 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
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments 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. Data type code Binding The use of a human name ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
family	S Σ	1..1	string	Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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	1..*	string	Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name. 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() \| (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 id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	Σ I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
gender	S Σ	1..1	codeBinding	Element id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. Comments 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. Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems). Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This 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. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	Σ	0..*	Address	There are no (further) constraints on this element Element id Patient.address Short description Addresses for the individual Definition Addresses 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The domestic partnership status of a person. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (bool) 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 tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo	I	0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` att-1: It the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: n/a rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: NK1-2 rim: name cda: n/a
telecom	I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2: A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is for postal addresses, not physical locations. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period	I	0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() 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
animal	Σ	0..0	BackboneElement	Element id Patient.animal Short description This patient is known to be an animal (non-human) Definition This patient is known to be an animal. Requirements Many clinical systems are extended to care for animal patients as well as human. Comments 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). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: player[classCode=ANM] cda: n/a argonaut-dq-dstu2: Patient.animal
communication	S	0..*	BackboneElement	Element id Patient.communication Short description 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. 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. 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() \| (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 id Patient.communication.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
language	S	1..1	CodeableConceptBinding	Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner	I	0..*	Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple usecases: 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. This 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'. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
other	Σ I	1..1	Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso - type of link Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The type of link between this patient resource and another patient resource. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: typeCode cda: n/a

The exact same parameters can be used for rendering by canonical:

Command 'tree' could not render: File was not found for 'http://hl7.org/fhir/StructureDefinition/Patient'

Below we'll only continue to show the file example.

Hybrid

Patient	I		Patient	Element id Patient Short description US Core Patient Profile 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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.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 `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole w5: administrative.individual argonaut-dq-dstu2: Patient
id	Σ	0..1	id	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may 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() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and 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. 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 in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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. 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() \| (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
race	S I	0..1	Extension	Element id Patient.extension:race Short 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 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() \| (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
ethnicity	S I	0..1	Extension	Element id Patient.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 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() \| (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
birthsex	S I	0..1	ExtensionBinding	Element id Patient.extension:birthsex Short description Optional Extensions Element Alternate names extensions, user content Definition A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC). 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 Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding Code for sex assigned at birth ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	S Σ	1..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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 v2: PID-3 rim: id cda: .id w5: id argonaut-dq-dstu2: Patient.identifier
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary (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 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. Data type code Binding Identifies the purpose for this identifier, if known . ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings 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 element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
system	S Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType argonaut-dq-dstu2: Patient.identifier.system
value	S Σ	1..1	string	Element id Patient.identifier.value Short 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 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
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments 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 This 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a rim: statusCode cda: n/a w5: status
name	S Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` 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
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments 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. Data type code Binding The use of a human name ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
family	S Σ	1..1	string	Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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	1..*	string	Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name. 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() \| (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 id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	Σ I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
gender	S Σ	1..1	codeBinding	Element id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. Comments 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. Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems). Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This 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. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	Σ	0..*	Address	There are no (further) constraints on this element Element id Patient.address Short description Addresses for the individual Definition Addresses 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The domestic partnership status of a person. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (bool) 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 tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo	I	0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` att-1: It the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: n/a rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: NK1-2 rim: name cda: n/a
telecom	I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2: A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is for postal addresses, not physical locations. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period	I	0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() 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
animal	Σ	0..0	BackboneElement	Element id Patient.animal Short description This patient is known to be an animal (non-human) Definition This patient is known to be an animal. Requirements Many clinical systems are extended to care for animal patients as well as human. Comments 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). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: player[classCode=ANM] cda: n/a argonaut-dq-dstu2: Patient.animal
communication	S	0..*	BackboneElement	Element id Patient.communication Short description 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. 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. 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() \| (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 id Patient.communication.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
language	S	1..1	CodeableConceptBinding	Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner	I	0..*	Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple usecases: 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. This 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'. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
other	Σ I	1..1	Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso - type of link Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The type of link between this patient resource and another patient resource. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: typeCode cda: n/a

Snapshot (default)

Patient	I		Patient	Element id Patient Short description US Core Patient Profile 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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.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 `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole w5: administrative.individual argonaut-dq-dstu2: Patient
id	Σ	0..1	id	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may 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() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and 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. 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 in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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. 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() \| (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
race	S I	0..1	Extension	Element id Patient.extension:race Short 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 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() \| (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
ethnicity	S I	0..1	Extension	Element id Patient.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 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() \| (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
birthsex	S I	0..1	ExtensionBinding	Element id Patient.extension:birthsex Short description Optional Extensions Element Alternate names extensions, user content Definition A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC). 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 Extension URL http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding Code for sex assigned at birth ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	S Σ	1..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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 v2: PID-3 rim: id cda: .id w5: id argonaut-dq-dstu2: Patient.identifier
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary (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 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. Data type code Binding Identifies the purpose for this identifier, if known . ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings 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 element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
system	S Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType argonaut-dq-dstu2: Patient.identifier.system
value	S Σ	1..1	string	Element id Patient.identifier.value Short 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 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
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments 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 This 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a rim: statusCode cda: n/a w5: status
name	S Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` 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
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments 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. Data type code Binding The use of a human name ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
family	S Σ	1..1	string	Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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	1..*	string	Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name. 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() \| (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 id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	Σ I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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
gender	S Σ	1..1	codeBinding	Element id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. Comments 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. Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems). Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This 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. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	Σ	0..*	Address	There are no (further) constraints on this element Element id Patient.address Short description Addresses for the individual Definition Addresses 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The domestic partnership status of a person. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (bool) 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 tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo	I	0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` att-1: It the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: n/a rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may 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() \| (children().count() > id.count())` Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: NK1-2 rim: name cda: n/a
telecom	I	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2: A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is for postal addresses, not physical locations. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period	I	0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() 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
animal	Σ	0..0	BackboneElement	Element id Patient.animal Short description This patient is known to be an animal (non-human) Definition This patient is known to be an animal. Requirements Many clinical systems are extended to care for animal patients as well as human. Comments 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). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: player[classCode=ANM] cda: n/a argonaut-dq-dstu2: Patient.animal
communication	S	0..*	BackboneElement	Element id Patient.communication Short description 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. 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. 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() \| (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 id Patient.communication.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
language	S	1..1	CodeableConceptBinding	Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. ?? (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner	I	0..*	Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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. Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization \| http://hl7.org/fhir/StructureDefinition/Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.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(http://hl7.org/fhir/StructureDefinition/Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple usecases: 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. This 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'. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description 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. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored 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 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. 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() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
other	Σ I	1..1	Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(http://hl7.org/fhir/StructureDefinition/Patient \| http://hl7.org/fhir/StructureDefinition/RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (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 %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso - type of link Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding The type of link between this patient resource and another patient resource. ?? (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: typeCode cda: n/a

Other resources

The render statement (without spaces between the brackets) enables you to render all other resources. See the below OperationDefinition (from https://simplifier.net/core-opdefs-stu3/ActivityDefinition-data-requirements) resource as an example.

Invocations

URL: [base]/ActivityDefinition/[id]/$data-requirements

Return Values (Out)

Name	Cardinality	Type	Documentation
return	1..1	Library	The result of the requirements gathering represented as a module-definition Library that describes the aggregate parameters, data requirements, and dependencies of the activity definition

The effect of invoking this operation is to determine the aggregate set of data requirements and dependencies for the activity definition. The result is a Library resource with a type of module-definition that contains all the parameter definitions and data requirements of the activity definition and any libraries referenced by it. Implementations SHOULD aggregate data requirements intelligently (i.e. by collapsing overlapping data requirements)