Patient

Concept

A person who is (or has been) receiving medication controlled by the HealthCareProvider using NCare.

Purpose

Recording relevant information to identify the patient for administrative purposes and process support.

Profiles

NL-Core-Patient

The basic Patient resource as defined by the Dutch Health and Care Information models or HCIM/ZIB (Dutch: Zorginformatiebouwsteen or ZIB) Patient, with additions from the HCIMs Nationality, MaritalStatus, ContactPerson, LanguageProficiency, HealthProfessional and HealthcareProvider (HCIM releases 2015, 2016 and 2017) The Patient resource in NCare is exchanged according to the FHIR NL-Core-Patient profile

Patient

Element id

Patient

Short description

Patient

Alternate names

SubjectOfCare Client Resident, Patiënt

Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Data type

Patient

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.1
hcim-patient-v3.0-2016EN: NL-CM:0.1.1
hcim-patient-v3.1-2017EN: NL-CM:0.1.1
hcim-payer-v1.2-2015EN: NL-CM:1.1.2
hcim-payer-v3.0-2016EN: NL-CM:1.1.2
hcim-payer-v3.1-2017EN: NL-CM:1.1.2
hcim-basicelements-v1.0-2017EN: NL-CM:0.0.3
hcim-basicelements-v1.0-2017EN: NL-CM:0.0.8
hcim-basicelements-v1.0-2017EN: NL-CM:0.0.12

0..1

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

Constraints

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

Mappings

rim: n/a

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

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

0..*

Extension

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

preferredPharmacy

0..1

Extension

Element id

Patient.extension:preferredPharmacy

Short description

References a patient's preferered pharmacy

Alternate names

extensions, user content, Verwijst naar de voorkeursapotheek van de patiënt

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension

Extension URL

http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy

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

nationality

0..*

Extension

Element id

Patient.extension:nationality

Short description

Nationality

Alternate names

extensions, user content, Nationaliteit

Definition

The nationality of the patient.

Comments

Data type

Extension

Extension URL

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

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
hcim-nationality-v2.0-2015EN: NL-CM:7.6.3
hcim-nationality-v3.0-2016EN: NL-CM:7.6.3
hcim-nationality-v3.0-2017EN: NL-CM:7.6.3

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:nationality.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. 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

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

code

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code

Short description

Nationality Code

Alternate names

extensions, user content

Definition

Code representing nationality of patient.

Comments

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:code.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Constraints

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

Fixed value

code

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

0..1

CodeableConceptBinding

Element id

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

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

CodeableConcept

Binding

Indicates the country of citizenship.

?? (extensible)

Constraints

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

Mappings

rim: n/a
rim: N/A

period

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:period

Short description

Nationality Period

Alternate names

extensions, user content

Definition

Period when nationality was effective.

Comments

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:period.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:period.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:nationality.extension:period.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

period

Mappings

rim: n/a
rim: N/A

valuePeriod

0..1

Period

There are no (further) constraints on this element

Element id

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

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

Period

Constraints

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

Mappings

rim: n/a
rim: N/A

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:nationality.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

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

Mappings

rim: n/a
rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

Patient.extension:nationality.value[x]

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Constraints

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

Mappings

rim: n/a
rim: N/A

legalStatus

0..2

Extension

Element id

Patient.extension:legalStatus

Short description

legalStatus

Alternate names

extensions, user content

Definition

The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

Comments

The concept LegalStatus of the HCIM FreedomRestrictingMeasures plays an important role in the context of mental healthcare (GGZ). This concept will become an independent HCIM with the next release of HCIM (2018 release).

The LegalStatus concept and associated ValueSet will be split in two concepts: legal status and representative. These concepts are currently captured in one ValueSet. It is possible to have a legal status AND a representative. Therefore, we allow this extension to have a cardinality of 0..2.

Data type

Extension

Extension URL

http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus

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
hcim-freedomrestrictingmeasures-v3.1-2017EN: NL-CM:14.3.2

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

1..1

CodeableConceptBinding

Element id

Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept

Short description

LegalStatus

Alternate names

JuridischeStatus

Definition

The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

Data type

CodeableConcept

Binding

LegalStatusCodelist

?? (extensible)

Constraints

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

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

coding

1..*

Coding

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

system

1..1

uri

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Data type

uri

Constraints

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

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints

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

Mappings

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

code

1..1

code

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

Constraints

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

Mappings

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

display

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.display

Short description

Representation defined by the system

Definition

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

Requirements

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

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: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints

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

Mappings

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

text

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:legalStatus.value[x]:valueCodeableConcept.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Constraints

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

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

lifeStance

0..*

Extension

Element id

Patient.extension:lifeStance

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension

Extension URL

http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

1..1

CodeableConceptBinding

Element id

Patient.extension:lifeStance.valueCodeableConcept:valueCodeableConcept

Short description

LifeStance

Alternate names

Levensovertuiging

Definition

Patient’s life stance and/or religion.

Data type

CodeableConcept

Binding

LevensovertuigingCodelijst

?? (preferred)

Constraints

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

Mappings

rim: n/a
rim: N/A
hcim-lifestance-v3.1-2017EN: NL-CM:7.5.2

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

coding

1..1

Coding

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

system

1..1

uri

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

Constraints

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

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.version

Short description

Version of the system - if relevant

Definition

Comments

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

code

1..1

code

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

Constraints

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

Mappings

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

display

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.display

Short description

Representation defined by the system

Definition

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

Requirements

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

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: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

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

text

0..1

string

There are no (further) constraints on this element

Element id

Patient.extension:lifeStance.value[x]:valueCodeableConcept.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

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: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

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

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

0..*

Identifier

Element id

Patient.identifier

Short description

PatientIdentificationNumber

Alternate names

Identificatienummer

Definition

The Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst).

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Identifier

Sliced:

Unordered, Open, by system(Value)

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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.7
hcim-patient-v3.0-2016EN: NL-CM:0.1.7
hcim-patient-v3.1-2017EN: NL-CM:0.1.7
hcim-basicelements-v1.0-2017EN: NL-CM:0.0.6

BSN

0..1

Identifier

Element id

Patient.identifier:BSN

Short description

BSN

Alternate names

BSN

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.identifier:BSN.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.identifier:BSN.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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:BSN.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

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Patient.identifier:BSN.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

1..1

uriFixed Value

Element id

Patient.identifier:BSN.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())

Fixed value

http://fhir.nl/fhir/NamingSystem/bsn

Mappings

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

value

1..1

string

Element id

Patient.identifier:BSN.value

Short description

BSN (Burgerservicenummer (Dutch person identification number))

Alternate names

BSN

Definition

Burgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare.

Comments

The official format according to the 'Logisch Ontwerp BSN 1.4.pdf' is N8..9 and SHALL conform to an 11-proof algorithm. In order to check if the number is 11-proof the number, if N8, SHALL be prefixed with a leading zero. The expected format in FHIR is N9 with leading zero applied to any N8 bsn.

Data type

string

Constraints

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

Examples

General

Example of a burgerservicenummer

123456782

Mappings

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

period

Σ I

0..1

Period

There are no (further) constraints on this element

Element id

Patient.identifier:BSN.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:BSN.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

Element id

Patient.active

Short description

Whether this patient's record is in active use

Definition

This field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP.

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

Σ I

0..*

http://fhir.nl/fhir/StructureDefinition/nl-core-humanname

Element id

Patient.name

Short description

NameInformation

Alternate names

Naamgegevens

Definition

A human's name with the ability to identify parts and usage.

Requirements

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

Comments

Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information.

The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around.

Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification.

The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the .use element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of .given names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials.

Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically:

Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
- They encounter a single instance
- And the .use element is absent
- And all the name parts are differentiated using the specified extensions
In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

.family = "Jongeneel-de Haas"
.given = "Irma" (with .given:iso21090EnQualifier = BR)
.family:humannameOwnName = "Jongeneel"
.family:humannamePartnerPrefix = "de "
.family:humannamePartnerName = "Haas"

Data type

http://fhir.nl/fhir/StructureDefinition/nl-core-humanname

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected
name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()
nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected
name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()

Examples

Structured HumanName (preferred above unstructured)

{
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order",
      "valueCode": "NL4"
    }
  ],
  "text": "Irma Jongeneel-de Haas",
  "family": "Jongeneel-de Haas",
  "_family": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
        "valueString": "Jongeneel"
      },
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix",
        "valueString": "de"
      },
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name",
        "valueString": "Haas"
      }
    ]
  },
  "given": [
    "Irma"
  ],
  "_given": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
          "valueCode": "CL"
        }
      ]
    }
  ]
}

Unstructured HumanName

{
  "text": "Irma Jongeneel-de Haas"
}

Mappings

rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: PID-5, PID-9
rim: name
cda: .patient.name
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.6
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.6
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.1
BRP: 02
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.6
hcim-patient-v3.0-2016EN: NL-CM:0.1.6
hcim-patient-v3.1-2017EN: NL-CM:0.1.6
hcim-payer-v1.2-2015EN: NL-CM:1.1.5
hcim-payer-v3.0-2016EN: NL-CM:1.1.5
hcim-payer-v3.1-2017EN: NL-CM:1.1.5

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

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

Comments

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

humannameAssemblyOrder

0..1

ExtensionBinding

There are no (further) constraints on this element

Element id

Patient.name.extension:humannameAssemblyOrder

Short description

Preferred display order of name parts

Alternate names

extensions, user content, Voorkeursvolgorde van de naamdelen.

Definition

A code that represents the preferred display order of the components of this human name.

Comments

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-assembly-order

Binding

Human Name Assembly Order

?? (required)

Permitted Values

http://nictiz.nl/fhir/ConceptMap/NaamgebruikCodelijst-to-HumanNameAssemblyOrder

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
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.34
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.34
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.7

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.extension:humannameAssemblyOrder.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.extension:humannameAssemblyOrder.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.extension:humannameAssemblyOrder.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-assembly-order

Mappings

rim: n/a
rim: N/A

valueCode

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

code

Binding

A code that represents the preferred display order of the components 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
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.name.use

Short description

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

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
hcim-payer-v1.2-2015EN: NL-CM:1.1.5
hcim-payer-v3.0-2016EN: NL-CM:1.1.5
hcim-payer-v3.1-2017EN: NL-CM:1.1.5

family

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family

Short description

Surname

Alternate names

surname, Achternaam

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

humannameOwnPrefix

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnPrefix

Short description

PrefixOwnName

Alternate names

extensions, user content, VoorvoegselGeslachtsnaam

Definition

The prefix portion (e.g. voorvoegsel) inclusive of the space between the prefix and the surname, if applicable, of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

Comments

An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-own-prefix

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
v2: FN.2
rim: ENXP where Qualifiers = (VV, R)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.38
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.38
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.11

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnPrefix.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnPrefix.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnPrefix.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-own-prefix

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnPrefix.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannameOwnName

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnName

Short description

OwnName

Alternate names

extensions, user content, Geslachtsnaam

Definition

The person’s official last name.

Comments

The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-own-name

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
v2: FN.3
rim: ENXP where Qualifiers = (BR)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.24
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.24
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.10

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnName.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnName.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnName.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-own-name

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannameOwnName.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannamePartnerPrefix

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerPrefix

Short description

PrefixSurname

Alternate names

extensions, user content, VoorvoegselGeslachtsnaamPartner

Definition

Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable.

Comments

An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix

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
v2: FN.4
rim: ENXP where Qualifiers = (VV, SP)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.39
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.39
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.9

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerPrefix.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerPrefix.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerPrefix.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerPrefix.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannamePartnerName

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerName

Short description

LastNamePartner

Alternate names

extensions, user content, GeslachtsnaamPartner

Definition

Partner’s official last name.

Comments

The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-partner-name

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
v2: FN.5
rim: ENXP where Qualifiers = (SP)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.25
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.25
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.8

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerName.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerName.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerName.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-partner-name

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.family.extension:humannamePartnerName.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

There are no (further) constraints on this element

Element id

Patient.name.family.value

Short description

Primitive value for string

Definition

Primitive value for string

Maximum string length

1048576

given

0..*

string

There are no (further) constraints on this element

Element id

Patient.name.given

Short description

Given

Alternate names

first name, middle name, Voornamen, Initialen, Roepnaam

Definition

Comments

Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier BR maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName.

Please see the compatibility note on the containing element as well!

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
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.26
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.35
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.27
BRP: 02.10
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.26
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.35
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.27
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.4
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.5
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.6

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.given.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.name.given.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

iso21090EnQualifier

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.name.given.extension:iso21090EnQualifier

Short description

LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV

Alternate names

extensions, user content

Definition

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

Comments

Used to indicate additional information about the name part and how it should be used.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier

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: ENXP.qualifier

0..1

string

There are no (further) constraints on this element

Element id

Patient.name.given.extension:iso21090EnQualifier.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.name.given.extension:iso21090EnQualifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.name.given.extension:iso21090EnQualifier.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier

Mappings

rim: n/a
rim: N/A

valueCode

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.name.given.extension:iso21090EnQualifier.value[x]:valueCode

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

code

Binding

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type

?? (required)

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

There are no (further) constraints on this element

Element id

Patient.name.given.value

Short description

Primitive value for string

Definition

Primitive value for string

Maximum string length

1048576

prefix

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

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

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..*

http://fhir.nl/fhir/StructureDefinition/nl-core-contactpoint

Element id

Patient.telecom

Short description

ContactInformation

Alternate names

Contactgegevens

Definition

A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'.

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

http://fhir.nl/fhir/StructureDefinition/nl-core-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()

Examples

Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number.

{
  "system": "phone",
  "value": "+31611234567",
  "use": "work"
}

Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number.

{
  "system": "phone",
  "value": "+31611234567",
  "use": "mobile"
}

Primary Home Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "home"
}

Temporary Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "temp"
}

Primary Work Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "work"
}

Primary Home Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "home"
}

Temporary Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "temp"
}

Primary Work Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "work"
}

Primary Home Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "home"
}

Temporary Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "temp"
}

Primary Work Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "work"
}

Primary Home Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "home"
}

Temporary Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "temp"
}

Primary Work Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "work"
}

Private email address

{
  "system": "email",
  "value": "giesput@myweb.nl",
  "use": "home"
}

Work email address

{
  "system": "email",
  "value": "example@workplace.nl",
  "use": "work"
}

Mappings

rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: PID-13, PID-14, PID-40
rim: telecom
cda: .telecom
hcim-contactinformation-v2.0.1-2015EN: NL-CM:0.1.5
hcim-contactinformation-v3.0-2016EN: NL-CM:0.1.5
hcim-contactinformation-v1.0-2017EN: NL-CM:20.6.1
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.5
hcim-patient-v3.0-2016EN: NL-CM:0.1.5
hcim-patient-v3.1-2017EN: NL-CM:0.1.5
hcim-payer-v1.2-2015EN: NL-CM:1.1.12
hcim-payer-v3.0-2016EN: NL-CM:1.1.12
hcim-payer-v3.1-2017EN: NL-CM:1.1.12

gender

0..1

codeBinding

Element id

Patient.gender

Short description

Gender

Alternate names

Geslacht

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)

Permitted Values

http://nictiz.nl/fhir/ConceptMap/GeslachtCodelijst-to-AdministrativeGender

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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.9
hcim-patient-v3.0-2016EN: NL-CM:0.1.9
hcim-patient-v3.1-2017EN: NL-CM:0.1.9

0..1

string

There are no (further) constraints on this element

Element id

Patient.gender.id

Short description

xml:id (or equivalent in JSON)

Definition

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

0..*

Extension

Element id

Patient.gender.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

GeslachtCodelijst

0..1

Extension

Element id

Patient.gender.extension:GeslachtCodelijst

Short description

Gender

Alternate names

extensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Geslacht

Definition

Patient’s administrative gender.

Comments

Data type

Extension

Extension URL

http://nictiz.nl/fhir/StructureDefinition/code-specification

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.gender.extension:GeslachtCodelijst.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.gender.extension:GeslachtCodelijst.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.gender.extension:GeslachtCodelijst.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://nictiz.nl/fhir/StructureDefinition/code-specification

Mappings

rim: n/a
rim: N/A

valueCodeableConcept

1..1

CodeableConceptBinding

Element id

Patient.gender.extension:GeslachtCodelijst.valueCodeableConcept:valueCodeableConcept

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

CodeableConcept

Binding

GeslachtCodelijst

?? (extensible)

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

There are no (further) constraints on this element

Element id

Patient.gender.value

Short description

Primitive value for code

Definition

Primitive value for code

Maximum string length

1048576

birthDate

0..1

date

Element id

Patient.birthDate

Short description

Patients date of birth. The date of birth is mandatory for a patient. An incomplete date, e.g. only year or only year + month, is permitted.

Alternate names

Geboortedatum

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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.10
hcim-patient-v3.0-2016EN: NL-CM:0.1.10
hcim-patient-v3.1-2017EN: NL-CM:0.1.10

deceased[x]

Σ ?!

0..1

Element id

Patient.deceased[x]

Short description

DeathIndicator/DateOfDeath

Alternate names

Overlijdensindicator/DatumOverlijden

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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.32
hcim-patient-v3.0-2016EN: NL-CM:0.1.32
hcim-patient-v3.1-2017EN: NL-CM:0.1.32
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.33
hcim-patient-v3.0-2016EN: NL-CM:0.1.33
hcim-patient-v3.1-2017EN: NL-CM:0.1.33

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 I

0..*

http://fhir.nl/fhir/StructureDefinition/nl-core-address

Element id

Patient.address

Short description

AddressInformation

Alternate names

AdresInformatie, Adresgegevens

Definition

This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

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

Separate address parts

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

Custom address types

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

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

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

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

Requirements

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

Comments

Note: address is for postal addresses, not physical locations.

Data type

http://fhir.nl/fhir/StructureDefinition/nl-core-address

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value
(extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not()))

Examples

Example of a Vacation Home address

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "HV",
            "display": "Vakantie adres"
          }
        ]
      }
    }
  ],
  "use": "temp",
  "line": [
    "Binnenkant 12A Hoog"
  ],
  "_line": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
          "valueString": "Binnenkant"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
          "valueString": "12"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix",
          "valueString": "A"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID",
          "valueString": "Hoog"
        }
      ]
    }
  ],
  "city": "Amsterdam",
  "state": "NH",
  "postalCode": "1000AA",
  "country": "NLD"
}

Example of a Primary Home address

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "HP",
            "display": "Officieel adres"
          }
        ]
      }
    },
    {
      "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official",
      "valueBoolean": true
    }
  ],
  "use": "home",
  "line": [
    "Binnenkant to 10"
  ],
  "_line": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
          "valueString": "Binnenkant"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator",
          "valueString": "to"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
          "valueString": "10"
        }
      ]
    }
  ],
  "city": "Amsterdam",
  "state": "NH",
  "postalCode": "1001AA",
  "country": "NLD"
}

Mappings

rim: n/a
v2: XAD
rim: AD
servd: Address
v2: PID-11
rim: addr
cda: .addr
hcim-address-v2.0.1-2015EN: NL-CM:0.1.4
hcim-addressinformation-v3.0-2016EN: NL-CM:0.1.4
hcim-addressinformation-v1.0-2017EN: NL-CM:20.5.1
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.4
hcim-patient-v3.0-2016EN: NL-CM:0.1.4
hcim-patient-v3.1-2017EN: NL-CM:0.1.4
hcim-payer-v1.2-2015EN: NL-CM:1.1.17
hcim-payer-v3.0-2016EN: NL-CM:1.1.17
hcim-payer-v3.1-2017EN: NL-CM:1.1.17

maritalStatus

0..1

CodeableConceptBinding

Element id

Patient.maritalStatus

Short description

MaritalStatus

Alternate names

BurgerlijkeStaat

Definition

This field contains a patient's most recent marital (civil) status. A person’s marital status according to the terms and definition in the Dutch civil code.

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
hcim-maritalstatus-v1.2.1-2015EN: NL-CM:7.9.2
hcim-maritalstatus-v3.0-2016EN: NL-CM:7.9.2
hcim-maritalstatus-v3.0-2017EN: NL-CM:7.9.2
hcim-familysituation-v1.0-2015EN: NL-CM:7.13.7
hcim-familysituation-v3.0-2016EN: NL-CM:7.13.7
hcim-familysituation-v3.0-2017EN: NL-CM:7.13.7

multipleBirth[x]

0..1

Element id

Patient.multipleBirth[x]

Short description

MultipleBirthIndicator

Alternate names

Meerlingindicator

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
hcim-patient-v2.0.1-2015EN: NL-CM:0.1.31
hcim-patient-v3.0-2016EN: NL-CM:0.1.31
hcim-patient-v3.1-2017EN: NL-CM:0.1.31

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

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

0..*

BackboneElement

Element id

Patient.contact

Short description

ContactPerson

Alternate names

Contactpersoon

Definition

Contacts are related persons in some way, but not all related persons are contacts. The HCIM ContactPerson is designed to deal with both related persons and contacts. An HCIM ContactPerson who is a contact, is expected to have an NL-CM:3.1.2 Role primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon'). See Patient.contact.relationship in slice 'role'.

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
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.1
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.1
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.1

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

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

Comments

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

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

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

Data type

CodeableConcept

Sliced:

Unordered, Open, by $this(Value)

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

relationship

0..*

CodeableConceptBinding

Element id

Patient.contact.relationship:relationship

Short description

Relationship

Alternate names

Relatie

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

Data type

CodeableConcept

Binding

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

?? (required)

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
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.3
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.3
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.3

role

0..*

CodeableConceptBinding

Element id

Patient.contact.relationship:role

Short description

Role

Alternate names

Rol

Definition

Expectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon')

Requirements

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

Comments

Data type

CodeableConcept

Binding

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

?? (required)

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
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.2
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.2
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.2

name

0..1

http://fhir.nl/fhir/StructureDefinition/nl-core-humanname

Element id

Patient.contact.name

Short description

NameInformation

Alternate names

Naamgegevens

Definition

A human's name with the ability to identify parts and usage.

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

Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
- They encounter a single instance
- And the .use element is absent
- And all the name parts are differentiated using the specified extensions
In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

.family = "Jongeneel-de Haas"
.given = "Irma" (with .given:iso21090EnQualifier = BR)
.family:humannameOwnName = "Jongeneel"
.family:humannamePartnerPrefix = "de "
.family:humannamePartnerName = "Haas"

Data type

http://fhir.nl/fhir/StructureDefinition/nl-core-humanname

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected
name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()
nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected
name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()

Examples

Structured HumanName (preferred above unstructured)

{
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order",
      "valueCode": "NL4"
    }
  ],
  "text": "Irma Jongeneel-de Haas",
  "family": "Jongeneel-de Haas",
  "_family": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
        "valueString": "Jongeneel"
      },
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix",
        "valueString": "de"
      },
      {
        "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name",
        "valueString": "Haas"
      }
    ]
  },
  "given": [
    "Irma"
  ],
  "_given": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
          "valueCode": "CL"
        }
      ]
    }
  ]
}

Unstructured HumanName

{
  "text": "Irma Jongeneel-de Haas"
}

Mappings

rim: n/a
v2: XPN
rim: EN (actually, PN)
servd: ProviderName
v2: NK1-2
rim: name
cda: n/a
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.6
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.6
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.1
BRP: 02
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.4
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.4
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.4

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

humannameAssemblyOrder

0..1

ExtensionBinding

There are no (further) constraints on this element

Element id

Patient.contact.name.extension:humannameAssemblyOrder

Short description

Preferred display order of name parts

Alternate names

extensions, user content, Voorkeursvolgorde van de naamdelen.

Definition

A code that represents the preferred display order of the components of this human name.

Comments

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-assembly-order

Binding

Human Name Assembly Order

?? (required)

Permitted Values

http://nictiz.nl/fhir/ConceptMap/NaamgebruikCodelijst-to-HumanNameAssemblyOrder

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
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.34
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.34
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.7

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.extension:humannameAssemblyOrder.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.extension:humannameAssemblyOrder.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.extension:humannameAssemblyOrder.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-assembly-order

Mappings

rim: n/a
rim: N/A

valueCode

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.contact.name.extension:humannameAssemblyOrder.valueCode:valueCode

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

code

Binding

A code that represents the preferred display order of the components 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
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.contact.name.use

Short description

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

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.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
hcim-payer-v1.2-2015EN: NL-CM:1.1.5
hcim-payer-v3.0-2016EN: NL-CM:1.1.5
hcim-payer-v3.1-2017EN: NL-CM:1.1.5

family

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family

Short description

Surname

Alternate names

surname, Achternaam

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

humannameOwnPrefix

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnPrefix

Short description

PrefixOwnName

Alternate names

extensions, user content, VoorvoegselGeslachtsnaam

Definition

Comments

An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-own-prefix

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
v2: FN.2
rim: ENXP where Qualifiers = (VV, R)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.38
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.38
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.11

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnPrefix.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnPrefix.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnPrefix.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-own-prefix

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnPrefix.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannameOwnName

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnName

Short description

OwnName

Alternate names

extensions, user content, Geslachtsnaam

Definition

The person’s official last name.

Comments

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-own-name

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
v2: FN.3
rim: ENXP where Qualifiers = (BR)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.24
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.24
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.10

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnName.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnName.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnName.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-own-name

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannameOwnName.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannamePartnerPrefix

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerPrefix

Short description

PrefixSurname

Alternate names

extensions, user content, VoorvoegselGeslachtsnaamPartner

Definition

Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable.

Comments

An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix

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
v2: FN.4
rim: ENXP where Qualifiers = (VV, SP)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.39
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.39
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.9

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerPrefix.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerPrefix.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerPrefix.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerPrefix.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

humannamePartnerName

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerName

Short description

LastNamePartner

Alternate names

extensions, user content, GeslachtsnaamPartner

Definition

Partner’s official last name.

Comments

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/humanname-partner-name

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
v2: FN.5
rim: ENXP where Qualifiers = (SP)
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.25
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.25
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.8

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerName.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerName.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerName.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/humanname-partner-name

Mappings

rim: n/a
rim: N/A

valueString

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.family.extension:humannamePartnerName.value[x]:valueString

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

There are no (further) constraints on this element

Element id

Patient.contact.name.family.value

Short description

Primitive value for string

Definition

Primitive value for string

Maximum string length

1048576

given

0..*

string

There are no (further) constraints on this element

Element id

Patient.contact.name.given

Short description

Given

Alternate names

first name, middle name, Voornamen, Initialen, Roepnaam

Definition

Comments

Please see the compatibility note on the containing element as well!

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
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.26
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.35
hcim-nameinformation-v2.0.1-2015EN: NL-CM:0.1.27
BRP: 02.10
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.26
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.35
hcim-nameinformation-v3.0-2016EN: NL-CM:0.1.27
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.4
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.5
hcim-nameinformation-v1.0.1-2017EN: NL-CM:20.4.6

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.given.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

iso21090EnQualifier

0..1

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension:iso21090EnQualifier

Short description

LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV

Alternate names

extensions, user content

Definition

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

Comments

Used to indicate additional information about the name part and how it should be used.

Data type

Extension

Extension URL

http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier

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: ENXP.qualifier

0..1

string

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension:iso21090EnQualifier.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

0..0

Extension

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension:iso21090EnQualifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension:iso21090EnQualifier.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier

Mappings

rim: n/a
rim: N/A

valueCode

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.contact.name.given.extension:iso21090EnQualifier.value[x]:valueCode

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

code

Binding

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type

?? (required)

Constraints

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

Mappings

rim: n/a
rim: N/A

value

0..1

There are no (further) constraints on this element

Element id

Patient.contact.name.given.value

Short description

Primitive value for string

Definition

Primitive value for string

Maximum string length

1048576

prefix

0..*

string

There are no (further) constraints on this element

Element id

Patient.contact.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

0..*

string

There are no (further) constraints on this element

Element id

Patient.contact.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.contact.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

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

0..*

http://fhir.nl/fhir/StructureDefinition/nl-core-contactpoint

Element id

Patient.contact.telecom

Short description

ContactInformation

Alternate names

Contactgegevens

Definition

Contact information includes a person's telephone numbers and email addresses. This datatype defines a common basis for expressing all contact information around the world, but adds extensions to express Dutch contacts specifically, according to the HCIM ContactInformation (v1.0, 2017). A Dutch ContactPoint still is a proper FHIR ContactPoint, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. The table below explains how the HCIM concepts are mapped to the various FHIR elements. The HCIM code itself should also be included using the TelecomType extension.

HCIM	`.ext:TelecomType`	`.system`	`.use`
Primary Home Land Line	LL	phone	home
Temporary Land Line	LL	phone	temp
Primary Work Land Line	LL	phone	work

Primary Home Fax	FAX	fax	home
Temporary Fax	FAX	fax	temp
Primary Work Fax	FAX	fax	work

Primary Home Mobile Phone	MC	phone	home
Temporary Mobile Phone	MC	phone	temp
Primary Work Mobile Phone	MC	phone	work

Primary Home Pager	PG	pager	home
Temporary Pager	PG	pager	temp
Primary Work Pager	PG	pager	work

Private email address		email	home
Work email address		email	work

Mobile phone number undetermined private/business		phone	mobile

Requirements

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

Comments

Telecommunication data details (phone/email) is physically modeled in the HCIM Patient, which is why the telecommunication mappings appear to be coming from the HCIM Patient instead of the HCIM ContactPerson

Data type

http://fhir.nl/fhir/StructureDefinition/nl-core-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()

Examples

Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number.

{
  "system": "phone",
  "value": "+31611234567",
  "use": "work"
}

Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number.

{
  "system": "phone",
  "value": "+31611234567",
  "use": "mobile"
}

Primary Home Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "home"
}

Temporary Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "temp"
}

Primary Work Land Line

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "LL",
            "display": "Land Line"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "work"
}

Primary Home Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "home"
}

Temporary Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "temp"
}

Primary Work Fax

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
            "code": "FAX",
            "display": "Fax"
          }
        ]
      }
    }
  ],
  "system": "fax",
  "value": "...",
  "use": "work"
}

Primary Home Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "home"
}

Temporary Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "temp"
}

Primary Work Mobile Phone

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "MC",
            "display": "Mobile Phone"
          }
        ]
      }
    }
  ],
  "system": "phone",
  "value": "...",
  "use": "work"
}

Primary Home Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "home"
}

Temporary Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "temp"
}

Primary Work Pager

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "PG",
            "display": "Pager"
          }
        ]
      }
    }
  ],
  "system": "pager",
  "value": "...",
  "use": "work"
}

Private email address

{
  "system": "email",
  "value": "giesput@myweb.nl",
  "use": "home"
}

Work email address

{
  "system": "email",
  "value": "example@workplace.nl",
  "use": "work"
}

Mappings

rim: n/a
v2: XTN
rim: TEL
servd: ContactPoint
v2: NK1-5, NK1-6, NK1-40
rim: telecom
cda: n/a
hcim-contactinformation-v2.0.1-2015EN: NL-CM:0.1.5
hcim-contactinformation-v3.0-2016EN: NL-CM:0.1.5
hcim-contactinformation-v1.0-2017EN: NL-CM:20.6.1
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.6
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.6
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.6

address

0..1

http://fhir.nl/fhir/StructureDefinition/nl-core-address

Element id

Patient.contact.address

Short description

AddressInformation

Alternate names

AdresInformatie, Adresgegevens

Definition

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

Separate address parts

Custom address types

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

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

http://fhir.nl/fhir/StructureDefinition/nl-core-address

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value
(extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not()))

Examples

Example of a Vacation Home address

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "HV",
            "display": "Vakantie adres"
          }
        ]
      }
    }
  ],
  "use": "temp",
  "line": [
    "Binnenkant 12A Hoog"
  ],
  "_line": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
          "valueString": "Binnenkant"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
          "valueString": "12"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix",
          "valueString": "A"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID",
          "valueString": "Hoog"
        }
      ]
    }
  ],
  "city": "Amsterdam",
  "state": "NH",
  "postalCode": "1000AA",
  "country": "NLD"
}

Example of a Primary Home address

{
  "extension": [
    {
      "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AddressUse",
            "code": "HP",
            "display": "Officieel adres"
          }
        ]
      }
    },
    {
      "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official",
      "valueBoolean": true
    }
  ],
  "use": "home",
  "line": [
    "Binnenkant to 10"
  ],
  "_line": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
          "valueString": "Binnenkant"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator",
          "valueString": "to"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
          "valueString": "10"
        }
      ]
    }
  ],
  "city": "Amsterdam",
  "state": "NH",
  "postalCode": "1001AA",
  "country": "NLD"
}

Mappings

rim: n/a
v2: XAD
rim: AD
servd: Address
v2: NK1-4
rim: addr
cda: n/a
hcim-address-v2.0.1-2015EN: NL-CM:0.1.4
hcim-addressinformation-v3.0-2016EN: NL-CM:0.1.4
hcim-addressinformation-v1.0-2017EN: NL-CM:20.5.1
hcim-contactperson-v1.2-2015EN: NL-CM:3.1.5
hcim-contactperson-v3.0-2016EN: NL-CM:3.1.5
hcim-contactperson-v3.1-2017EN: NL-CM:3.1.5

gender

0..1

codeBinding

There are no (further) constraints on this element

Element id

Patient.contact.gender

Short description

male | female | other | unknown

Definition

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

Requirements

Needed to address the person correctly.

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

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

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

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..1

BackboneElement

There are no (further) constraints on this element

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.animal.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.animal.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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.animal.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

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

species

1..1

CodeableConcept

There are no (further) constraints on this element

Element id

Patient.animal.species

Short description

E.g. Dog, Cow

Definition

Identifies the high level taxonomic categorization of the kind of animal.

Requirements

Need to know what kind of animal.

Comments

If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

Data type

CodeableConcept

Binding

The species of an animal.

?? (example)

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-35
rim: code
cda: n/a

breed

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Patient.animal.breed

Short description

E.g. Poodle, Angus

Definition

Identifies the detailed categorization of the kind of animal.

Requirements

May need to know the specific kind within the species.

Comments

Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

Data type

CodeableConcept

Binding

The breed of an animal.

?? (example)

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-37
rim: playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code
cda: n/a

genderStatus

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Patient.animal.genderStatus

Short description

E.g. Neutered, Intact

Definition

Indicates the current state of the animal's reproductive organs.

Requirements

Gender status can affect housing and animal behavior.

Comments

Data type

CodeableConcept

Binding

The state of the animal's reproductive organs.

?? (example)

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: N/A
rim: genderStatusCode
cda: n/a

communication

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

Alternate names

Taalvaardigheid

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
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.1

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

0..*

Extension

Element id

Patient.communication.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

languageProficiency

0..*

Extension

Element id

Patient.communication.extension:languageProficiency

Short description

Proficiency level of the communication

Alternate names

extensions, user content

Definition

Proficiency level of the communication.

Comments

The HCIM concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captuperd using a mocked offical HL7 core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping:

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

Data type

Extension

Extension URL

http://nictiz.nl/fhir/StructureDefinition/patient-proficiency

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
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.6
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.7
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.8

0..1

string

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

type

1..1

Extension

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:type

Short description

The proficiency type of the communication

Alternate names

extensions, user content

Definition

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

Comments

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:type.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:type.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:type.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

type

Mappings

rim: n/a
rim: N/A

valueCoding

1..1

CodingBinding

Element id

Patient.communication.extension:languageProficiency.extension:type.valueCoding:valueCoding

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

Coding

Binding

The proficiency type for the communication.

?? (extensible)

Constraints

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

Mappings

rim: n/a
rim: N/A

level

1..1

Extension

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:level

Short description

The proficiency level of the communication

Alternate names

extensions, user content

Definition

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

Comments

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

0..1

string

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:level.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

0..*

Extension

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:level.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.extension:level.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

level

Mappings

rim: n/a
rim: N/A

valueCoding

1..1

CodingBinding

Element id

Patient.communication.extension:languageProficiency.extension:level.valueCoding:valueCoding

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Data type

Coding

Binding

The proficiency level for the communication.

?? (extensible)

Constraints

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

Mappings

rim: n/a
rim: N/A

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

Patient.communication.extension:languageProficiency.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Constraints

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

Fixed value

http://nictiz.nl/fhir/StructureDefinition/patient-proficiency

Mappings

rim: n/a
rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

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

Short description

Value of extension

Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Constraints

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

Mappings

rim: n/a
rim: N/A

comment

0..*

Extension

Element id

Patient.communication.extension:comment

Short description

Comment

Alternate names

extensions, user content, Toelichting

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension

Extension URL

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

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
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.5

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

Comments

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

1..1

CodeableConceptBinding

Element id

Patient.communication.language

Short description

CommunicationLanguage

Alternate names

CommunicatieTaal

Definition

The language of communication.

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 FHIR value set http://hl7.org/fhir/valueset-languages.html is used instead of the HCIM value set CommunicationLanguageCodelist. The FHIR value set uses the code system urn:ietf:bcp:47 which includes the ISO-639-2 alpha code system used by the HCIM value set.

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
hcim-languageproficiency-v3.1-2017EN: NL-CM:7.12.3

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

0..1

Reference(http://fhir.nl/fhir/StructureDefinition/nl-core-organization | http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)

Element id

Patient.generalPractitioner

Short description

GeneralPractitioner

Alternate names

careProvider, Huisarts

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://fhir.nl/fhir/StructureDefinition/nl-core-organization | http://fhir.nl/fhir/StructureDefinition/nl-core-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
hcim-healthcareprovider-v1.2-2015EN: NL-CM:17.2.1
hcim-healthcareprovider-v3.0-2016EN: NL-CM:17.2.1
hcim-healthcareprovider-v3.1.1-2017EN: NL-CM:17.2.1
hcim-healthprofessional-v1.2.1-2015EN: NL-CM:17.1.1
hcim-healthprofessional-v3.0-2016EN: NL-CM:17.1.1
hcim-healthprofessional-v3.2-2017EN: NL-CM:17.1.1

0..1

string

There are no (further) constraints on this element

Element id

Patient.generalPractitioner.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

0..*

Extension

Element id

Patient.generalPractitioner.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

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

practitionerRole

0..1

Extension

Element id

Patient.generalPractitioner.extension:practitionerRole

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension

Extension URL

http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference

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

reference

Σ I

0..1

string

There are no (further) constraints on this element

Element id

Patient.generalPractitioner.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Constraints

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

Mappings

rim: n/a
rim: N/A

identifier

0..1

Identifier

There are no (further) constraints on this element

Element id

Patient.generalPractitioner.identifier

Short description

Logical reference, when literal reference is not known

Definition

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

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
rim: .identifier

display

0..1

string

There are no (further) constraints on this element

Element id

Patient.generalPractitioner.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Constraints

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

Mappings

rim: n/a
rim: 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

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

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

Comments

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

Comments

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

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

Identifiers

Besides the BSN Identifier specified by the NL-Core-Patient profile, FHIR Server for NCare also supports a local system identifier and an external identifier.

The system for the local system identifier is http://ncare.nl/fhir/NamingSystem/localid This identifier is used by NCare and cannot be changed. The value of this identifier is the same as the resource.id element in case of a Patient resource. The identifier can be used for searches or chaining. If the system identifier is specified in a UPDATE request, it will be used as conditional parameter, meaning it will look for a patient with this id to update. If it's used in a CREATE, an error will be thrown.

The system for external identifier is http://ncare.nl/fhir/NamingSystem/externalid. This identifier can be set through UPDATE and CREATE and can be used for later references (eg. store the id of your system)

Custom rules

CREATE command has some extra rules

When creating a new patient record, some extra rules apply for ncare on top of the default nl-core-patient rules.

the identifier:BSN field is mandatory
the generalPractitioner field is mandatory, it needs to contain a valid reference to a generalPractitioner known by NCare
the managingOrganization field is mandatory unless your authorization token only has access to one organization, in that case that organization is set as the managingOrganization
the extension http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy needs to be added to the patient's extensions field (with a valid pharmacy reference as it's value). If these mandatory fields are not added for new clients, an error-response will be returned.

Important: Please note that if you have successfully created a new patient, the patient will not show up in the NCare application untill you created a valid Encounter for the patient also.

Ignored properties

Although the complete NL-Core-Patient profile is accepted by FHIR Server for NCare, we only store the patient data that is needed for the NCare application. The properties we don't store can therefore not be returned when the resource is retrieved with a get of course.

The properties of NL-Core-Patient that we ignore are:

multipleBirth
animal
link
photo -> although NCare uses photo's, this is not supported by the FHIR Server for NCare yet yet

REST API

API	Supported	Command	Comment
read	yes	GET /Patient/
vread	no		If a version is specified, we ignore it, the latest version is always returned
update	yes	PUT /Patient/
update with optimistic locking	yes	PUT /Patient/ If-Match: W/""	https://www.hl7.org/fhir/http.html#concurrency
update (conditional)	yes	PUT /Patient?[search parameters]	https://www.hl7.org/fhir/http.html#cond-update
patch	yes	PATCH /Patient/	Support for JSON Patch only. We have included a workaround to use JSON Patch in a bundle in this PR.
patch (conditional)	no
delete	no		A hard or soft delete for a patient is not supported. If you want to register the patient as no longer being under the care of your organization, you can specify that with an Encounter
delete (conditional)	no
history	no
create	yes	POST /Patient PUT /Patient	Support both POST/PUT (Upsert)
create (conditional)	yes
search	yes	GET /Patient?[search parameters]	See Overview of FHIR Search.
chained search	no	chained searches are not supported atm
reverse chained search	no	chained searches are not supported atm
batch	no
transaction	no
paging	yes
intermediaries	no

Example

ncare | J Fransen, Is - SIMPLIFIER.NET

<Patient xmlns="http://hl7.org/fhir">
    <id value="30000000" />
    <meta>
        <versionId value="ticks/637635713173880955" />
        <lastUpdated value="2021-08-03T07:08:37.3880955+00:00" />
        <profile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" />
    </meta>
    <extension url="http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy">
        <valueReference>
            <reference value="Organization/Pharmacy.2382" />
            <display value="Apotheek De Schelft" />
        </valueReference>
    </extension>
    <identifier>
        <use value="official" />
        <system value="http://fhir.nl/fhir/NamingSystem/bsn" />
        <value value="43566029" />
    </identifier>
    <identifier>
        <use value="official" />
        <system value="http://ncare.nl/fhir/NamingSystem/localid" />
        <value value="30000000" />
    </identifier>
    <name>
        <extension url="http://hl7.org/fhir/StructureDefinition/humanname-assembly-order">
            <valueCode value="NL3" />
        </extension>
        <use value="official" />
        <text value="J Fransen, Is" />
        <family value="J Fransen, Is" />
    </name>
    <gender value="male" />
    <birthDate value="1929-12-31" />
    <deceasedBoolean value="true" />
    <address>
        <extension url="http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType">
            <valueCodeableConcept>
                <coding>
                    <system value="http://hl7.org/fhir/v3/AddressUse" />
                    <code value="HP" />
                </coding>
                <text value="Officieel adres" />
            </valueCodeableConcept>
        </extension>
        <extension url="http://fhir.nl/fhir/StructureDefinition/nl-core-address-official">
            <valueBoolean value="true" />
        </extension>
        <use value="home" />
        <line value="Zijstraat 1">
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
                <valueString value="Zijstraat" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
                <valueString value="1" />
            </extension>
        </line>
        <city value="Amsterdam" />
        <postalCode value="1000AA" />
    </address>
    <managingOrganization>
        <reference value="Organization/Organization.48202" />
        <display value="Huize NControl" />
    </managingOrganization>
</Patient>