Pan-Canadian Patient Summary (PS-CA)
current 
TI Ballot - For a full list of available versions, see the Directory of published versions
Patient (PS-CA)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Patient
Examples
Description
This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources.
References to this resource
AllergyIntolerancePSCA, AllergyIntoleranceNotSupportedPSCA, CompositionPSCA, ConditionPSCA, ConditionNotSupportedPSCA, DiagnosticReportPSCA, FamilyMemberHistoryPSCA, ImagingStudyPSCA, ImmunizationPSCA, MedicationRequestPSCA, MedicationStatementPSCA, MedicationStatementNotSupportedPSCA, ObservationAlcoholUsePSCA, ObservationResultsPSCA, ObservationResultsLaboratoryPathologyPSCA, ObservationResultsRadiologyPSCA, ObservationSocialHistoryPSCA, ObservationTobaccoUsePSCA, ProcedurePSCA
Resource Content
| PatientPSCA (Patient) | C | Patient | |
| id | Σ | 0..1 | id |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| individual-recordedSexOrGender | C | 0..* | Extension(Complex) |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | SO Σ | 0..* | Identifier |
| (All Slices) | |||
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| type | Σ | 0..1 | CodeableConceptBinding |
| system | SO Σ | 0..1 | uri |
| value | Σ | 1..1 | string |
| period | Σ C | 0..1 | Period |
| assigner | Σ C | 0..1 | Reference(Organization) |
| JHN | SO Σ | 0..* | Identifier |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| versionCode | C | 0..1 | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| type | Σ | 1..1 | CodeableConceptBindingPattern |
| system | SO Σ | 1..1 | uri |
| value | Σ | 1..1 | string |
| period | Σ C | 0..1 | Period |
| assigner | Σ C | 0..1 | Reference(Organization) |
| MRN | SO Σ | 0..* | Identifier |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| type | Σ | 1..1 | CodeableConceptBindingPattern |
| system | SO Σ | 1..1 | uri |
| value | Σ | 1..1 | string |
| period | Σ C | 0..1 | Period |
| assigner | Σ C | 0..1 | Reference(Organization) |
| active | Σ ?! | 0..1 | boolean |
| name | SO Σ C | 1..* | HumanName |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| text | SO Σ | 0..1 | string |
| family | SO Σ | 0..1 | string |
| given | SO Σ | 0..* | string |
| prefix | Σ | 0..* | string |
| suffix | Σ | 0..* | string |
| period | Σ C | 0..1 | Period |
| telecom | Σ C | 0..* | ContactPoint |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | SO Σ C | 0..1 | codeBinding |
| value | SO Σ | 0..1 | string |
| use | SO Σ ?! | 0..1 | codeBinding |
| rank | Σ | 0..1 | positiveInt |
| period | Σ C | 0..1 | Period |
| gender | SO Σ | 0..1 | codeBinding |
| birthDate | SO Σ | 1..1 | date |
| deceased[x] | Σ ?! | 0..1 | |
| deceasedBoolean | boolean | ||
| deceasedDateTime | dateTime | ||
| address | SO Σ | 0..* | Address |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| type | Σ | 0..1 | codeBinding |
| text | Σ | 0..1 | string |
| line | SO Σ | 0..* | string |
| city | SO Σ | 0..1 | string |
| district | Σ | 0..1 | string |
| state | Σ | 0..1 | string |
| postalCode | SO Σ | 0..1 | string |
| country | SO Σ | 0..1 | string |
| period | Σ C | 0..1 | Period |
| maritalStatus | 0..1 | CodeableConceptBinding | |
| multipleBirth[x] | 0..1 | ||
| multipleBirthBoolean | boolean | ||
| multipleBirthInteger | integer | ||
| photo | C | 0..* | Attachment |
| contact | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| relationship | 0..* | CodeableConceptBinding | |
| name | 0..1 | HumanName | |
| telecom | C | 0..* | ContactPoint |
| address | 0..1 | Address | |
| gender | 0..1 | codeBinding | |
| organization | C | 0..1 | Reference(Organization) |
| period | C | 0..1 | Period |
| communication | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| language | 1..1 | CodeableConceptBinding | |
| preferred | 0..1 | boolean | |
| generalPractitioner | C | 0..* | Reference(Organization | Practitioner | PractitionerRole) |
| managingOrganization | Σ C | 0..1 | Reference(Organization) |
| link | Σ ?! | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| other | Σ C | 1..1 | Reference(Patient | RelatedPerson) |
| type | Σ | 1..1 | codeBinding |
| PatientPSCA (Patient) | Patient | ||
| extension | |||
| individual-recordedSexOrGender | 0..* | Extension(Complex) | |
| identifier | SO | ||
| (All Slices) | |||
| type | |||
| system | SO | ||
| value | 1.. | ||
| JHN | 0..* | ||
| versionCode | 0..1 | Extension | |
| type | 1.. | Pattern | |
| system | 1.. | ||
| MRN | 0..* | ||
| type | 1.. | Pattern | |
| system | 1.. | ||
| name | SO C | 1.. | |
| text | SO | ||
| family | SO | ||
| given | SO | ||
| telecom | |||
| system | SO | ||
| value | SO | ||
| use | SO | ||
| gender | SO | ||
| birthDate | SO | 1.. | |
| address | SO | ||
| line | SO | ||
| city | SO | ||
| postalCode | SO | ||
| country | SO | ||
| generalPractitioner |
<description value="This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources." />
<copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
</discriminator>
</slicing>
</element>
<definition value="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide" />
</type>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</discriminator>
</slicing>
</element>
<comment value="The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation." />
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</element>
<definition value="Federal patient and person health numbers used by all jurisdictions across Canada" />
</element>
</type>
</element>
</coding>
</patternCodeableConcept>
</element>
</element>
<comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
</element>
</coding>
</patternCodeableConcept>
</element>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided" />
<human value="Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present." />
<expression value="(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()" />
<xpath value="(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))" />
</constraint>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<definition value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element" />
<comment value="Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance" />
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<comment value="While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined." />
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
</differential>
</StructureDefinition>
{
"description": "This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources.",
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
}
},
{
"definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide",
{
"http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
]
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
},
{
"comment": "The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation."
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
},
{
},
{
{
"http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
]
}
]
},
{
}
},
{
},
{
"comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
},
{
}
},
{
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
{
"human": "Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.",
"expression": "(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()",
"xpath": "(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))",
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
"comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance",
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined.",
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
}
]
}
}
Terminology bindings (Differential)
Terminology bindings (Snapshot)
Constraints
| Path | Id | Grade | Details | Expression |
|---|---|---|---|---|
| Patient.name | core-pat-1 | error | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() |
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
The following elements are considered Must Support in the IPS-UV specification that are relaxed in this version of the PS-CA profile:
Patient.telecomPatient.generalPractitionerNote: Systems that support these elements are encouraged to send them in patient summaries
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
Patient.identifier- slices added for JHN & MRN identifier types anticipated to be used by early implementers
Other differences between the IPS and PS-CA Include:
Patient.name.text: comment added