| PatientEHR (Patient) | C | | Patient | There are no (further) constraints on this element Element idPatient Short descriptionInformation about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
Patient Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-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-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists()
Mappings- rim: Entity. Role, or Act
- rim: Patient[classCode=PAT]
- cda: ClinicalDocument.recordTarget.patientRole
|
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
string |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idPatient.meta Short descriptionMetadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Meta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idPatient.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
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).
code BindingCommonLanguages (preferred) Binding extensionsConstraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| text | | 0..1 | Narrative | There are no (further) constraints on this element Element idPatient.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Narrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| contained | | 0..* | Resource | There are no (further) constraints on this element Element idPatient.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Resource Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| identifier | S Σ | 1..* | Identifier | Element idPatient.identifier Short descriptionAn identifier for this patient DefinitionAn identifier for this patient.
Patients are almost always assigned specific numerical identifiers.
Identifier SlicingUnordered, Open, by type(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.identifier
- v2: PID-3
- rim: id
- cda: .id
|
| (All Slices) | | | | The requirements in this element apply to all slices |
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.identifier.use Short descriptionusual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code BindingIdentifies the purpose for this identifier, if known .
IdentifierUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: N/A
- rim: Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.identifier.type Short descriptionDescription of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
CodeableConcept BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identifier Type Codes (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.5
- rim: Role.code or implied by context
|
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idPatient.identifier.system Short descriptionThe namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhttp://www.acme.com/identifiers/patient Mappings- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.identifier.value Short descriptionThe value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General123456 Mappings- 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 | 0..1 | Period | There are no (further) constraints on this element Element idPatient.identifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.identifier.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
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.
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| JHN | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element idPatient.identifier:JHN Short descriptionAn identifier for this patient DefinitionAn identifier for this patient.
Patients are almost always assigned specific numerical identifiers.
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.identifier
- v2: PID-3
- rim: id
- cda: .id
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| ReasonForNoHCN | C | 0..1 | Extension(CodeableConcept) | Element idPatient.identifier:JHN.extension:ReasonForNoHCN Short descriptionOptional Extensions Element Alternate namesextensions, user content DefinitionA reason for not providing the patient's health card number as a business identifier
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.
Extension(CodeableConcept) Extension URLhttp://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-reason-for-no-HCN-EXT ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| url | | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.url Short descriptionidentifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL.
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.
uri Fixed valuehttp://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-reason-for-no-HCN-EXT Mappings |
| value[x] | | 0..1 | | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x] Short descriptionValue of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data typeCodeableConcept |
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| system | Σ | 0..1 | uriFixed Value | Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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 reference to some definition that establishes the system clearly and unambiguously.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed valuehttp://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-reason-for-no-HCN-EXT Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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 | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:ReasonForNoHCN.value[x].text Short descriptionPlain text representation of the concept DefinitionA 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| HCNVersionCode | C | 0..1 | Extension | Element idPatient.identifier:JHN.extension:HCNVersionCode Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-id-health-card-version-code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:HCNVersionCode.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:HCNVersionCode.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| url | | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:HCNVersionCode.url Short descriptionidentifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL.
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.
uri Fixed valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-id-health-card-version-code Mappings |
| value[x] | | 0..1 | | There are no (further) constraints on this element Element idPatient.identifier:JHN.extension:HCNVersionCode.value[x] Short descriptionValue of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| valueBase64Binary | | | base64Binary | There are no (further) constraints on this element Data typebase64Binary |
| valueBoolean | | | boolean | There are no (further) constraints on this element Data typeboolean |
| valueCanonical | | | canonical() | There are no (further) constraints on this element Data typecanonical() |
| valueCode | | | code | There are no (further) constraints on this element Data typecode |
| valueDate | | | date | There are no (further) constraints on this element Data typedate |
| valueDateTime | | | dateTime | There are no (further) constraints on this element Data typedateTime |
| valueDecimal | | | decimal | There are no (further) constraints on this element Data typedecimal |
| valueId | | | id | There are no (further) constraints on this element Data typeid |
| valueInstant | | | instant | There are no (further) constraints on this element Data typeinstant |
| valueInteger | | | integer | There are no (further) constraints on this element Data typeinteger |
| valueMarkdown | | | markdown | There are no (further) constraints on this element Data typemarkdown |
| valueOid | | | oid | There are no (further) constraints on this element Data typeoid |
| valuePositiveInt | | | positiveInt | There are no (further) constraints on this element Data typepositiveInt |
| valueString | | | string | There are no (further) constraints on this element Data typestring |
| valueTime | | | time | There are no (further) constraints on this element Data typetime |
| valueUnsignedInt | | | unsignedInt | There are no (further) constraints on this element Data typeunsignedInt |
| valueUri | | | uri | There are no (further) constraints on this element Data typeuri |
| valueUrl | | | url | There are no (further) constraints on this element Data typeurl |
| valueUuid | | | uuid | There are no (further) constraints on this element Data typeuuid |
| valueAddress | | | Address | There are no (further) constraints on this element Data typeAddress |
| valueAge | | | Age | There are no (further) constraints on this element Data typeAge |
| valueAnnotation | | | Annotation | There are no (further) constraints on this element Data typeAnnotation |
| valueAttachment | | | Attachment | There are no (further) constraints on this element Data typeAttachment |
| valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data typeCodeableConcept |
| valueCoding | | | Coding | There are no (further) constraints on this element Data typeCoding |
| valueContactPoint | | | ContactPoint | There are no (further) constraints on this element Data typeContactPoint |
| valueCount | | | Count | There are no (further) constraints on this element Data typeCount |
| valueDistance | | | Distance | There are no (further) constraints on this element Data typeDistance |
| valueDuration | | | Duration | There are no (further) constraints on this element Data typeDuration |
| valueHumanName | | | HumanName | There are no (further) constraints on this element Data typeHumanName |
| valueIdentifier | | | Identifier | There are no (further) constraints on this element Data typeIdentifier |
| valueMoney | | | Money | There are no (further) constraints on this element Data typeMoney |
| valuePeriod | | | Period | There are no (further) constraints on this element Data typePeriod |
| valueQuantity | | | Quantity | There are no (further) constraints on this element Data typeQuantity |
| valueRange | | | Range | There are no (further) constraints on this element Data typeRange |
| valueRatio | | | Ratio | There are no (further) constraints on this element Data typeRatio |
| valueSampledData | | | SampledData | There are no (further) constraints on this element Data typeSampledData |
| valueSignature | | | Signature | There are no (further) constraints on this element Data typeSignature |
| valueTiming | | | Timing | There are no (further) constraints on this element Data typeTiming |
| valueContactDetail | | | ContactDetail | There are no (further) constraints on this element Data typeContactDetail |
| valueContributor | | | Contributor | There are no (further) constraints on this element Data typeContributor |
| valueDataRequirement | | | DataRequirement | There are no (further) constraints on this element Data typeDataRequirement |
| valueExpression | | | Expression | There are no (further) constraints on this element Data typeExpression |
| valueParameterDefinition | | | ParameterDefinition | There are no (further) constraints on this element Data typeParameterDefinition |
| valueRelatedArtifact | | | RelatedArtifact | There are no (further) constraints on this element Data typeRelatedArtifact |
| valueTriggerDefinition | | | TriggerDefinition | There are no (further) constraints on this element Data typeTriggerDefinition |
| valueUsageContext | | | UsageContext | There are no (further) constraints on this element Data typeUsageContext |
| valueDosage | | | Dosage | There are no (further) constraints on this element Data typeDosage |
| valueMeta | | | Meta | There are no (further) constraints on this element Data typeMeta |
| valueReference | | | Reference() | There are no (further) constraints on this element Data typeReference() |
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.identifier:JHN.use Short descriptionusual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code BindingIdentifies the purpose for this identifier, if known .
IdentifierUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: N/A
- rim: Role.code or implied by context
|
| type | S Σ | 1..1 | CodeableConceptBinding | Element idPatient.identifier:JHN.type Short descriptionDescription of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
CodeableConcept BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
IdentifierTypeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.5
- rim: Role.code or implied by context
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| system | S Σ | 1..1 | uriFixed Value | Element idPatient.identifier:JHN.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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 reference to some definition that establishes the system clearly and unambiguously.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed valuehttp://terminology.hl7.org/CodeSystem/v2-0203 Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | codeFixed Value | Element idPatient.identifier:JHN.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed valueJHN Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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 | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.type.text Short descriptionPlain text representation of the concept DefinitionA 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idPatient.identifier:JHN.system Short descriptionThe namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhttp://www.acme.com/identifiers/patient Mappings- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.identifier:JHN.value Short descriptionThe value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General123456 Mappings- 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 | 0..1 | Period | There are no (further) constraints on this element Element idPatient.identifier:JHN.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.identifier:JHN.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
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.
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| MRN | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element idPatient.identifier:MRN Short descriptionAn identifier for this patient DefinitionAn identifier for this patient.
Patients are almost always assigned specific numerical identifiers.
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.identifier
- v2: PID-3
- rim: id
- cda: .id
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:MRN.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.identifier:MRN.use Short descriptionusual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code BindingIdentifies the purpose for this identifier, if known .
IdentifierUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: N/A
- rim: Role.code or implied by context
|
| type | S Σ | 1..1 | CodeableConceptBinding | Element idPatient.identifier:MRN.type Short descriptionDescription of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
CodeableConcept BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
IdentifierTypeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.5
- rim: Role.code or implied by context
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| system | S Σ | 1..1 | uriFixed Value | Element idPatient.identifier:MRN.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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 reference to some definition that establishes the system clearly and unambiguously.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed valuehttp://terminology.hl7.org/CodeSystem/v2-0203 Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | codeFixed Value | Element idPatient.identifier:MRN.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Fixed valueMR Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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 | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.type.text Short descriptionPlain text representation of the concept DefinitionA 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idPatient.identifier:MRN.system Short descriptionThe namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhttp://www.acme.com/identifiers/patient Mappings- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.identifier:MRN.value Short descriptionThe value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General123456 Mappings- 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 | 0..1 | Period | There are no (further) constraints on this element Element idPatient.identifier:MRN.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.identifier:MRN.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
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.
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
|
| active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.active Short descriptionWhether this patient's record is in active use DefinitionWhether this patient record is in active use.
Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.
It is often used to filter patient lists to exclude inactive patients
Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Need to be able to mark a patient record as not to be used because it was created in error.
If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
This resource is generally assumed to be active if no value is provided for the active element
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.status
- rim: statusCode
- cda: n/a
|
| name | S Σ | 0..* | HumanName | There are no (further) constraints on this element Element idPatient.name Short descriptionA name associated with the patient DefinitionA name associated with the individual.
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
HumanName Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-5, PID-9
- rim: name
- cda: .patient.name
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.name.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.name.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.name.use Short descriptionusual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name.
Allows the appropriate name for a particular context of use to be selected from among a set of names.
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
code BindingNameUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.7, but often indicated by which field contains the name
- rim: unique(./use)
- servd: ./NamePurpose
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.name.text Short descriptionText representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
A renderable, unencoded form.
Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: implied by XPN.11
- rim: ./formatted
|
| family | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.name.family Short descriptionFamily name (often called 'Surname') Alternate namessurname DefinitionThe 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.
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.1/FN.1
- rim: ./part[partType = FAM]
- servd: ./FamilyName
|
| given | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.name.given Short descriptionGiven names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionCommentsIf only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.2 + XPN.3
- rim: ./part[partType = GIV]
- servd: ./GivenNames
|
| prefix | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.name.prefix Short descriptionParts that come before the name DefinitionPart 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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.5
- rim: ./part[partType = PFX]
- servd: ./TitleCode
|
| suffix | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.name.suffix Short descriptionParts that come after the name DefinitionPart 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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN/4
- rim: ./part[partType = SFX]
|
| period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idPatient.name.period Short descriptionTime period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person.
Allows names to be placed in historical context.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.13 + XPN.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| telecom | S Σ | 0..* | ContactPoint | There are no (further) constraints on this element Element idPatient.telecom Short descriptionA contact detail for the individual DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
People have (primary) ways to contact them in some way such as phone, email.
A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
ContactPoint Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-13, PID-14, PID-40
- rim: telecom
- cda: .telecom
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.telecom.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.telecom.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| telephone-note | C | 0..1 | Extension(string) | Element idPatient.telecom.extension:telephone-note Short descriptionOptional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources.
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.
Extension(string) Extension URLhttp://ontariohealth.ca/fhir/StructureDefinition/ca-on-accdr-ext-note ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| system | S Σ C | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.telecom.system Short descriptionphone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact.
code BindingTelecommunications form for contact point.
ContactPointSystem (required) ConditionsThe cardinality or value of this element may be affected by these constraints: cpt-2 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XTN.3
- rim: ./scheme
- servd: ./ContactPointType
|
| value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.telecom.value Short descriptionThe actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Need to support legacy numbers that are not in a tightly controlled format.
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XTN.1 (or XTN.12)
- rim: ./url
- servd: ./Value
|
| use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.telecom.use Short descriptionhome | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
code BindingContactPointUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XTN.2 - but often indicated by field
- rim: unique(./use)
- servd: ./ContactPointPurpose
|
| rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idPatient.telecom.rank Short descriptionSpecify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idPatient.telecom.period Short descriptionTime period when the contact point was/is in use DefinitionTime period when the contact point was/is in use.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: N/A
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| gender | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.gender Short descriptionmale | female | other | unknown DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Needed for identification of the individual, in combination with (at least) name and birth date.
The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.
code BindingThe gender of a person used for administrative purposes.
AdministrativeGender (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-8
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- cda: .patient.administrativeGenderCode
|
| birthDate | S Σ | 0..1 | date | There are no (further) constraints on this element Element idPatient.birthDate Short descriptionThe date of birth for the individual DefinitionThe date of birth for the individual.
Age of the individual drives many clinical processes.
At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
date Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-7
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
- cda: .patient.birthTime
- loinc: 21112-8
|
| deceased[x] | Σ ?! | 0..1 | | There are no (further) constraints on this element Element idPatient.deceased[x] Short descriptionIndicates if the individual is deceased or not DefinitionIndicates if the individual is deceased or not.
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.
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-30 (bool) and PID-29 (datetime)
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
- cda: n/a
|
| deceasedBoolean | | | boolean | There are no (further) constraints on this element Data typeboolean |
| deceasedDateTime | | | dateTime | There are no (further) constraints on this element Data typedateTime |
| address | S Σ | 0..* | Address | There are no (further) constraints on this element Element idPatient.address Short descriptionAn address for the individual DefinitionAn address for the individual.
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Patient may have multiple addresses with different uses or applicable periods.
Address Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-11
- rim: addr
- cda: .addr
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.address.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.address.use Short descriptionhome | work | temp | old | billing - purpose of this address DefinitionThe purpose of this address.
Allows an appropriate address to be chosen from a list of many.
Applications can assume that an address is current unless it explicitly says that it is temporary or old.
code BindingAddressUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhome Mappings- v2: XAD.7
- rim: unique(./use)
- servd: ./AddressPurpose
|
| type | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.address.type Short descriptionpostal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
code BindingThe type of an address (physical / postal).
AddressType (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalboth Mappings- v2: XAD.18
- rim: unique(./use)
- vcard: address type parameter
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.text Short descriptionText representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
A renderable, unencoded form.
Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General137 Nowhere Street, Erewhon 9132 Mappings- v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
- rim: ./formatted
- vcard: address label parameter
|
| line | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.address.line Short descriptionStreet name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General137 Nowhere Street Mappings- v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
- rim: AD.part[parttype = AL]
- vcard: street
- servd: ./StreetAddress (newline delimitted)
|
| city | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.city Short descriptionName of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
GeneralErewhon Mappings- v2: XAD.3
- rim: AD.part[parttype = CTY]
- vcard: locality
- servd: ./Jurisdiction
|
| district | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.district Short descriptionDistrict name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county).
District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
GeneralMadison Mappings- v2: XAD.9
- rim: AD.part[parttype = CNT | CPA]
|
| state | S Σ | 0..1 | stringBinding | Element idPatient.address.state Short descriptionSub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
string BindingProvinceStateCodeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XAD.4
- rim: AD.part[parttype = STA]
- vcard: region
- servd: ./Region
|
| postalCode | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.postalCode Short descriptionPostal code for area Alternate namesZip DefinitionA postal code designating a region defined by the postal service.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General9132 Mappings- v2: XAD.5
- rim: AD.part[parttype = ZIP]
- vcard: code
- servd: ./PostalIdentificationCode
|
| country | S Σ | 0..1 | stringBinding | Element idPatient.address.country Short descriptionCountry (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted.
ISO 3166 3 letter codes can be used in place of a human readable country name.
string BindingCountryCodeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XAD.6
- rim: AD.part[parttype = CNT]
- vcard: country
- servd: ./Country
|
| period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idPatient.address.period Short descriptionTime period when address was/is in use DefinitionTime period when address was/is in use.
Allows addresses to be placed in historical context.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General{
"start": "2010-03-23",
"end": "2010-07-01"
}Mappings- v2: XAD.12 / XAD.13 + XAD.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| maritalStatus | | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.maritalStatus Short descriptionMarital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status.
Most, if not all systems capture it.
CodeableConcept BindingThe domestic partnership status of a person.
Marital Status Codes (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-16
- rim: player[classCode=PSN]/maritalStatusCode
- cda: .patient.maritalStatusCode
|
| multipleBirth[x] | | 0..1 | | There are no (further) constraints on this element Element idPatient.multipleBirth[x] Short descriptionWhether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-24 (bool), PID-25 (integer)
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
- cda: n/a
|
| multipleBirthBoolean | | | boolean | There are no (further) constraints on this element Data typeboolean |
| multipleBirthInteger | | | integer | There are no (further) constraints on this element Data typeinteger |
| photo | | 0..* | Attachment | There are no (further) constraints on this element Element idPatient.photo Short descriptionImage of the patient DefinitionRequirementsMany EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Guidelines:
- Use id photos, not clinical photos.
- Limit dimensions to thumbnail.
- Keep byte count low to ease resource updates.
Attachment Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: OBX-5 - needs a profile
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
- cda: n/a
|
| contact | S C | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.contact Short descriptionA contact party (e.g. guardian, partner, friend) for the patient DefinitionA contact party (e.g. guardian, partner, friend) for the patient.
Need to track people you can contact about the patient.
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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - pat-1: SHALL at least contain a contact's details or a reference to an organization
name.exists() or telecom.exists() or address.exists() or organization.exists()
Mappings- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| relationship | S | 0..* | CodeableConceptEHRBinding | Element idPatient.contact.relationship Short descriptionConcept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Used to determine which contact person is the most relevant to approach, depending on circumstances.
For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.
CodeableConceptEHR BindingThe nature of the relationship between a patient and a contact person for that patient.
PatientContactRelationshipEHR (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: NK1-7, NK1-3
- rim: code
- cda: n/a
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.relationship.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.relationship.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | S Σ | 1..1 | CodingEHR | There are no (further) constraints on this element Element idPatient.contact.relationship.coding Short descriptionA reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
CodingEHR ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
- 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
|
| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.relationship.text Short descriptionPlain text representation of the concept DefinitionA 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| name | S | 0..1 | HumanName | There are no (further) constraints on this element Element idPatient.contact.name Short descriptionA name associated with the contact person DefinitionA name associated with the contact person.
Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
HumanName Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: NK1-2
- rim: name
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.name.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.name.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.name.use Short descriptionusual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name.
Allows the appropriate name for a particular context of use to be selected from among a set of names.
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
code BindingNameUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.7, but often indicated by which field contains the name
- rim: unique(./use)
- servd: ./NamePurpose
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.name.text Short descriptionText representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
A renderable, unencoded form.
Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: implied by XPN.11
- rim: ./formatted
|
| family | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.name.family Short descriptionFamily name (often called 'Surname') Alternate namessurname DefinitionThe 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.
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.1/FN.1
- rim: ./part[partType = FAM]
- servd: ./FamilyName
|
| given | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.contact.name.given Short descriptionGiven names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionCommentsIf only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.2 + XPN.3
- rim: ./part[partType = GIV]
- servd: ./GivenNames
|
| prefix | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.contact.name.prefix Short descriptionParts that come before the name DefinitionPart 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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.5
- rim: ./part[partType = PFX]
- servd: ./TitleCode
|
| suffix | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.contact.name.suffix Short descriptionParts that come after the name DefinitionPart 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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN/4
- rim: ./part[partType = SFX]
|
| period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idPatient.contact.name.period Short descriptionTime period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person.
Allows names to be placed in historical context.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XPN.13 + XPN.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| telecom | S | 0..* | ContactPoint | There are no (further) constraints on this element Element idPatient.contact.telecom Short descriptionA contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address.
People have (primary) ways to contact them in some way such as phone, email.
Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
ContactPoint Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: NK1-5, NK1-6, NK1-40
- rim: telecom
- cda: n/a
|
| address | S | 0..1 | Address | There are no (further) constraints on this element Element idPatient.contact.address Short descriptionAddress for the contact person DefinitionAddress for the contact person.
Need to keep track where the contact person can be contacted per postal mail or visited.
Address Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: NK1-4
- rim: addr
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.address.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.address.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.address.use Short descriptionhome | work | temp | old | billing - purpose of this address DefinitionThe purpose of this address.
Allows an appropriate address to be chosen from a list of many.
Applications can assume that an address is current unless it explicitly says that it is temporary or old.
code BindingAddressUse (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhome Mappings- v2: XAD.7
- rim: unique(./use)
- servd: ./AddressPurpose
|
| type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.address.type Short descriptionpostal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
code BindingThe type of an address (physical / postal).
AddressType (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalboth Mappings- v2: XAD.18
- rim: unique(./use)
- vcard: address type parameter
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.address.text Short descriptionText representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
A renderable, unencoded form.
Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General137 Nowhere Street, Erewhon 9132 Mappings- v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
- rim: ./formatted
- vcard: address label parameter
|
| line | S Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.contact.address.line Short descriptionStreet name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General137 Nowhere Street Mappings- v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
- rim: AD.part[parttype = AL]
- vcard: street
- servd: ./StreetAddress (newline delimitted)
|
| city | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.address.city Short descriptionName of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
GeneralErewhon Mappings- v2: XAD.3
- rim: AD.part[parttype = CTY]
- vcard: locality
- servd: ./Jurisdiction
|
| district | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.address.district Short descriptionDistrict name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county).
District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
GeneralMadison Mappings- v2: XAD.9
- rim: AD.part[parttype = CNT | CPA]
|
| state | S Σ | 0..1 | stringBinding | Element idPatient.contact.address.state Short descriptionSub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
string BindingProvinceStateCodeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XAD.4
- rim: AD.part[parttype = STA]
- vcard: region
- servd: ./Region
|
| postalCode | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.address.postalCode Short descriptionPostal code for area Alternate namesZip DefinitionA postal code designating a region defined by the postal service.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General9132 Mappings- v2: XAD.5
- rim: AD.part[parttype = ZIP]
- vcard: code
- servd: ./PostalIdentificationCode
|
| country | S Σ | 0..1 | stringBinding | Element idPatient.contact.address.country Short descriptionCountry (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted.
ISO 3166 3 letter codes can be used in place of a human readable country name.
string BindingCountryCodeEHR (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: XAD.6
- rim: AD.part[parttype = CNT]
- vcard: country
- servd: ./Country
|
| period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idPatient.contact.address.period Short descriptionTime period when address was/is in use DefinitionTime period when address was/is in use.
Allows addresses to be placed in historical context.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General{
"start": "2010-03-23",
"end": "2010-07-01"
}Mappings- v2: XAD.12 / XAD.13 + XAD.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| gender | | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.gender Short descriptionmale | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Needed to address the person correctly.
code BindingThe gender of a person used for administrative purposes.
AdministrativeGender (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: NK1-15
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- cda: n/a
|
| organization | C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.contact.organization Short descriptionOrganization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working.
For guardians or business related contacts, the organization is relevant.
Reference(Organization) ConditionsThe cardinality or value of this element may be affected by these constraints: pat-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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 idPatient.contact.period Short descriptionThe period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: effectiveTime
- cda: n/a
|
| communication | S | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.communication Short descriptionA language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health.
If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: LanguageCommunication
- cda: patient.languageCommunication
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| language | S | 1..1 | CodeableConceptEHRBinding | Element idPatient.communication.language Short descriptionConcept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.
CodeableConceptEHR BindingLanguageEHR (extensible) Binding extensionsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-15, LAN-2
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
- cda: .languageCode
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.language.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | S Σ | 0..1 | CodingEHR | There are no (further) constraints on this element Element idPatient.communication.language.coding Short descriptionA reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
CodingEHR ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
- 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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.coding.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.language.coding.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idPatient.communication.language.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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 reference to some definition that establishes the system clearly and unambiguously.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.coding.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idPatient.communication.language.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | S Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.coding.display.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references)
string |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.language.coding.display.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| translation | S C | 0..* | Extension(Complex) | There are no (further) constraints on this element Element idPatient.communication.language.coding.display.extension:translation Short descriptionLanguage Translation (Localization) Alternate namesextensions, user content DefinitionLanguage translation from base language of resource to another language.
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.
Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/translation ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| value | | 0..1 | System.String | There are no (further) constraints on this element Element idPatient.communication.language.coding.display.value Short descriptionPrimitive value for string DefinitionData typeSystem.String Maximum string length1048576 |
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.communication.language.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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 | S Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.language.text Short descriptionPlain text representation of the concept DefinitionA 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
|
| preferred | | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.communication.preferred Short descriptionLanguage preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level).
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.
This language is specifically identified for communicating healthcare information.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-15
- rim: preferenceInd
- cda: .preferenceInd
|
| generalPractitioner | S | 0..* | Reference(PractitionerEHR) | Element idPatient.generalPractitioner Short descriptionPatient's nominated primary care provider Alternate namescareProvider DefinitionPatient's nominated care provider.
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.
Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.
Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Reference(PractitionerEHR) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PD1-4
- rim: subjectOf.CareEvent.performer.AssignedEntity
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.generalPractitioner.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.generalPractitioner.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| reference | S Σ C | 0..1 | string | There are no (further) constraints on this element Element idPatient.generalPractitioner.reference Short descriptionLiteral reference, Relative, internal or absolute URL DefinitionA 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.
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.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ref-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idPatient.generalPractitioner.type Short descriptionType the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri BindingAa resource (or, for logical models, the URI of the logical model).
ResourceType (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idPatient.generalPractitioner.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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.
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.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.generalPractitioner.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| managingOrganization | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.managingOrganization Short descriptionOrganization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record.
Need to know who recognizes this patient record, manages and updates it.
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).
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: scoper
- cda: .providerOrganization
|
| link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.link Short descriptionLink to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient.
There are multiple use cases:
- Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
- Distribution of patient information across multiple servers.
There is no assumption that linked patient records have mutual links.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: outboundLink
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.link.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.link.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.link.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| other | Σ | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element idPatient.link.other Short descriptionThe other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to.
Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Reference(Patient | RelatedPerson) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: PID-3, MRG-1
- rim: id
- cda: n/a
|
| type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idPatient.link.type Short descriptionreplaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource.
code BindingThe type of link between this patient resource and another patient resource.
LinkType (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
