Start profiling

Introduction

In this module you will learn how to build your first profile. We will use Forge, the official HL7® FHIR® profile editor, to build our profiles. You can download Forge for free.

The topics covered in this module are:

Building your first profile
Constraining elements
Constraining data types

Reading material

The process of making a profile is a process of constraining different aspects of a base resource or data type. Any change you make to a base resource is called a constraint and can only limit the information contained in the base resources. Constraints are any limitations to elements in a base resource in terms of limiting the allowable ValueSets, limiting or eliminating cardinality and adding elements (extensions). Through various constraints you make the profile more specific to your needs, thereby making it more limited in terms of the information that satisfies the requirements set forth in the profile.

1. Building your first profile

The first step in building any profile is to select a base resource or data type (e.g. a Patient). You may also choose to further constrain a profile (e.g. MyPatient) and select this profile as your base profile. The next step after choosing your base resource, is to give your resource a name and a unique canonical URL. In Forge, you can do so in the Properties tab.

2. Constraining elements

Now that you have built your profile, you can start constraining its elements. For example, the following properties can be constrained: Cardinality, Fixed values, Data types, Must-Support and Is-Modifier. Each of these properties is explained in more detail below.

2.1 Cardinality

An important aspect in profiling is constraining the cardinality of different elements. The cardinality of an element sets the number of allowable repetitions for that element.

Cardinality	Meaning
0..0	not used
0..1	optional to one
0..*	optional to many
1..1	one required
1..*	at least one

Profiles cannot break the rules established in the base specification. The rules of cardinality specify that the minimum cardinality of the new range must be less than or equal to the maximum cardinality and the maximum cardinality must be greater than or equal to the new minimum cardinality.

2.2 Fixed values

You can use fixed values to specify a value that SHALL be exactly the value for this element in the instance. For example, you can specify that identifier.system shall always be http://hl7.org/fhir/sid/us-ssn to specify that this identifier shall be a US Social Security Number.

Complex values can also be fixed. A complex data type is usually a composite of other existing data types, like Coding, which consists of multiple strings, a uri and a boolean.

An example of fixing a complex value is when creating a profile specifically for respiratory rate. You will create a profile on Observation that has a Fixed value on Observation.code (CodeableConcept) using a LOINC code, system and display name, to specify which vital sign is specified.

Example

<element id="Observation.code">
    <path value="Observation.code"/>
    <fixedCodeableConcept>
        <coding>
            <system value="http://loinc.org"/>
            <code value="9279-1"/>
            <display value=" Respiratory rate"/>
        </coding>
    </fixedCodeableConcept>
</element>

This instead of fixing the three individual elements separately.

2.3 Choice of Data types ( value[x] )

In FHIR resources, some elements end with an [x], meaning that this element has multiple types. For example, Patient.multipleBirth[x] can be either a boolean (example 1) or an integer (example 2). A boolean value indicates whether a Patient is one of many (true or false). If present, an integer value means that the patient is one of many, indicating the actual birth order.

Example 1

<Patient xmlns="http://hl7.org/fhir">
  <gender value="female"/>
  <birthDate value="2017-01-01"/>
  <multipleBirthBoolean value="true"/>
</Patient>

Example 2

<Patient xmlns="http://hl7.org/fhir">
  <gender value="female"/>
  <birthDate value="2017-01-01"/>
  <!-- Patient is the second born child of many -->
  <multipleBirthInteger value="2"/>
</Patient>

Choice data types always have a maximum cardinality of 1, meaning that the element cannot repeat. This means that only one of the optional data types must be chosen.

When profiling, you can't add optional data types to an element, you only constrain "value[x]" elements to the optional data types you want to allow. An example can be that you contain a Patient resource to only allow multipleBirth booleans and no integer, because your system does not have any support for birth order. Or if you are profiling an Observation resource for Body Weight, you may want to constrain Observation.value[x] to only allow for the Quantity data type and not the String, Integer, CodeableConcept or any other data type that doesn't make sense in the context of defining a person's body weight.

2.4 mustSupport

This is a boolean (true or false) property that identifies an element that must be supported, that is understandable, to all sending and receiving bodies. The minimum cardinality of "mustSupport" elements may be set to 0 meaning that it isn't required but if a value is sent it must be digestible by the receiving system. Note that the specification itself never labels any elements as mustSupport, this is done in Resource Profiles (StructureDefinitions). The flag is intended for use in profiles that have a defined implementation context. Since "mustSupport" is such an overloaded term in Health IT, it's up to the specifier to define what is meant by this.

One of the more common definitions of mustSupport
If the sending system has the information specified in the element, it should put it in the resource, and the receiving party cannot ignore and must process that information accordingly.

Some options to consider when thinking about your mustSupport strategy are:

Make everything in the differential mustSupport=true like US core (http://hl7.org/fhir/us/core/general-guidance.html#must-support)
Make nothing mustSupport=true and instead add a notion that altered elements in the profile in itself suggests "mustSupport" for those elements.
Weigh at least every optional element path for importance and potentially make paths with a minimum cardinality of 1 mustSupport=true (although that is sort of redundant)

2.5 isModifier

This is a boolean (true or false) property that identifies an element as a modifier for a resource. If an element shows a true value in the “IsModifer" property then its contents, once filled in, have the ability to change the meaning of the resource. The value of the element then shape the interpretation of the rest of the elements in this resource and the overall meaning. The "IsModifier" elements should have a minimum cardinality of 1 within a resource and should be explained in the narrative of a resource. For example, if the value of the verificationStatus element of the resource AllergyIntolerance is set to 'Refuted' this affects the entire meaning of the resource.

Only the definition of an element can set IsModifier to true - either the specification itself or where an extension is originally defined. IsModifier of already existing elements cannot be set from true to false in profiles.

3. Constraining data types

There are situations in which you want to constrain data types instead of individual resources. This is efficient when you want to apply the same constraints across different resources. It also makes it easier to maintain as changes only need to be made one place, your new data type. SimpleQuantity is an example of a Profile on a data type. Another example is given below.

Example

Create a new profile on HumanName (e.g. NL-HumanName)
Add constraints that are applicable to all instances of HumanName in your scenario (e.g. add the element Prefix)
Now in the profiles of Patient, Practitioner, RelatedPerson, or any other resource where it would also be useful, change the data type from "HumanName" to "NL-HumanName".

Real-life examples

Here below are examples of customers that we helped building profiles.

ZorgDomein

ZorgDomein is a digital platform where care providers can request or offer care and exchange patient information in a safe and secure way. To facilitate the implementation of a FHIR-interface between ZorgDomein and hospital information systems, profiles are specified on the following core resources: Patient, Practitioner, Organization, Coverage, Composition, DocumentReference, ReferralRequest, EpisodeOfCare, Encounter, Observation, AllergyIntolerance and MedicationStatement.

The example below shows the differential of the zd-practitioner profile, so it only shows the differences compared to the core resource Practitioner. In this case, the differences are as following:

The minimum cardinality of the following elements are set to 1 (meaning these elements are mandatory):
- Identifier.system
- Identifier.value
- Telecom.system
- Telecom.value
- Gender
The value for the naming system of the identifier is fixed to the UZI number of the care provider
The data types of the name and address elements are set to the Dutch core profiles for these data types:
- nl-core-humanname
- nl-core-address

Nictiz

Nictiz is the centre of expertise for standardization and eHealth in The Netherlands. HL7 Netherlands core and MedMij profiles are published on Simplifier. MedMij is a national project that aims to give Dutch citizens integrated access to all their health data in one personal health environment. FHIR is used as a standard to exchange health information between the involved parties. The profiles are based on standardized clinical building blocks called Health and Care Information Models (HCIM).

The example below shows the Dutch national profile for Patient. It contains the following constraints and extensions:

An extension to specify preferredPharmacy, with the data type set to nl-core-organization
An extension to specify nationality, with a binding on a national code list
A slice on identifier for the Dutch national identifier (BSN) where:
- The value of system is fixed to the BSN naming system
- The minimum cardinality of system and value elements are set to 1
The data types of the name, address and generalPractitioner elements are set to the Dutch core profiles for these data types:
- nl-core-humanname
- nl-core-address
- nl-core-organization or nl-core-practitioner

Patient	I		Patient	Element Id Patient Short description Patient Alternate names SubjectOfCare Client Resident, Patiënt Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data Type Patient Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` Mappings rim:Entity. Role, or Act rim:Patient[classCode=PAT] cda:ClinicalDocument.recordTarget.patientRole w5:administrative.individual hcim-patient-v2.0.1-2015EN:NL-CM:0.1.1 hcim-patient-v3.0-2016EN:NL-CM:0.1.1 hcim-patient-v3.1-2017EN:NL-CM:0.1.1 hcim-payer-v1.2-2015EN:NL-CM:1.1.2 hcim-payer-v3.0-2016EN:NL-CM:1.1.2 hcim-payer-v3.1-2017EN:NL-CM:1.1.2 hcim-basicelements-v1.0-2017EN:NL-CM:0.0.3 hcim-basicelements-v1.0-2017EN:NL-CM:0.0.8 hcim-basicelements-v1.0-2017EN:NL-CM:0.0.12
extension	I	0..*	Extension	Element Id Patient.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
preferredPharmacy	I	0..1	Extension(Reference(nl-core-organization))	Element Id Patient.extension:preferredPharmacy Short description References a patient's preferered pharmacy Alternate names extensions, user content, Verwijst naar de voorkeursapotheek van de patiënt Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Reference(nl-core-organization)) Extension URL http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
nationality	I	0..*	Extension	Element Id Patient.extension:nationality Short description Nationality Alternate names extensions, user content, Nationaliteit Definition The nationality of the patient. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/patient-nationality Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-nationality-v2.0-2015EN:NL-CM:7.6.3 hcim-nationality-v3.0-2016EN:NL-CM:7.6.3 hcim-nationality-v3.0-2017EN:NL-CM:7.6.3
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
code	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension:code Short description Nationality Code Alternate names extensions, user content Definition Code representing nationality of patient. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension:code.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value code Mappings rim:n/a rim:N/A
valueCodeableConcept		0..1	CodeableConceptBinding	Element Id Patient.extension:nationality.extension:code.valueCodeableConcept:valueCodeableConcept Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type CodeableConcept Binding Indicates the country of citizenship. NationaliteitCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
period	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension:period Short description Nationality Period Alternate names extensions, user content Definition Period when nationality was effective. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension:period.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value period Mappings rim:n/a rim:N/A
valuePeriod		0..1	Period	There are no (further) constraints on this element Element Id Patient.extension:nationality.extension:period.valuePeriod:valuePeriod Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:nationality.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/patient-nationality Mappings rim:n/a rim:N/A
value[x]		0..0		There are no (further) constraints on this element Element Id Patient.extension:nationality.value[x] Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
legalStatus	I	0..2	Extension(CodeableConcept)	Element Id Patient.extension:legalStatus Short description legalStatus Alternate names extensions, user content Definition The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status. Comments The concept LegalStatus of the HCIM FreedomRestrictingMeasures plays an importand role in the context of mental healthcare (GGZ). This concept will become an independent HCIM with the next release of HCIM (2018 release). The LegalStatus concept and associated valueset will be split in two: legalstatus and guardianship. These concept are currently captured in one valueset. It is possible to have a legalstatus AND a representative. Therefore, we allow this extension to have a cardinality of 0..2. Data Type Extension(CodeableConcept) Extension URL http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-freedomrestrictingmeasures-v3.1-2017EN:NL-CM:14.3.2
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:legalStatus.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus Mappings rim:n/a rim:N/A
valueCodeableConcept		1..1	CodeableConceptBinding	Element Id Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept Short description LegalStatus Alternate names JuridischeStatus Definition The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status. Comments A stream of bytes, base64 encoded Data Type CodeableConcept Binding LegalStatusCodelist JuridischeStatusCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element Id Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
system	Σ	1..1	uri	There are no (further) constraints on this element Element Id Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.7 rim:./codeSystemVersion orim:*fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element Id Patient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:Sometimes implied by being first rim:CD.codingRationale orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.extension:legalStatus.value[x]:valueCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
lifeStance	I	0..*	Extension(CodeableConcept)	Element Id Patient.extension:lifeStance Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:lifeStance.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance Mappings rim:n/a rim:N/A
valueCodeableConcept		1..1	CodeableConceptBinding	Element Id Patient.extension:lifeStance.valueCodeableConcept:valueCodeableConcept Short description LifeStance Alternate names Levensovertuiging Definition Patient’s life stance and/or religion. Comments A stream of bytes, base64 encoded Data Type CodeableConcept Binding LevensovertuigingCodelijst LevensovertuigingCodelijst (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A hcim-lifestance-v3.1-2017EN:NL-CM:7.5.2
coding	Σ	1..1	Coding	There are no (further) constraints on this element Element Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
system	Σ	1..1	uri	There are no (further) constraints on this element Element Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.7 rim:./codeSystemVersion orim:*fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.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 Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:Sometimes implied by being first rim:CD.codingRationale orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.extension:lifeStance.value[x]:valueCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
identifier	Σ	0..*	Identifier	Element Id Patient.identifier Short description PatientIdentificationNumber Alternate names Identificatienummer Definition The Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst). Requirements Patients are almost always assigned specific numerical identifiers. Data Type Identifier Sliced: Unordered, Open, by system(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier v2:PID-3 rim:id cda:.id w5:id hcim-patient-v2.0.1-2015EN:NL-CM:0.1.7 hcim-patient-v3.0-2016EN:NL-CM:0.1.7 hcim-patient-v3.1-2017EN:NL-CM:0.1.7 hcim-basicelements-v1.0-2017EN:NL-CM:0.0.6
BSN	Σ	0..1	Identifier	Element Id Patient.identifier:BSN Short description BSN Alternate names BSN Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier v2:PID-3 rim:id cda:.id w5:id
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.identifier:BSN.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data Type code Binding Identifies the purpose for this identifier, if known . identifier-use (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.identifier:BSN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. identifier-type (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	Σ	1..1	uriFixed Value	Element Id Patient.identifier:BSN.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://fhir.nl/fhir/NamingSystem/bsn Mappings rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	1..1	string	Element Id Patient.identifier:BSN.value Short description BSN (Burgerservicenummer (Dutch person identification number)) Alternate names BSN Definition Burgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare. Comments The official format according to the 'Logisch Ontwerp BSN 1.4.pdf' is N8..9 and SHALL conform to an 11-proof algorithm. In order to check if the number is 11-proof the number, if N8, SHALL be prefixed with a leading zero. The expected format in FHIR is N9 with leading zero applied to any N8 bsn. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 Example of a burgerservicenummer 123456782 Mappings rim:n/a v2:CX.1 / EI.1 rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd:./Value
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Patient.identifier:BSN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.identifier:BSN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:CX.4 / (CX.4,CX.9,CX.10) rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd:./IdentifierIssuingAuthority
active	Σ ?!	0..1	boolean	Element Id Patient.active Short description Whether this patient's record is in active use Definition This field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim:n/a rim:statusCode cda:n/a w5:status
name	Σ I	0..*	nl-core-humanname	Element Id Patient.name Short description NameInformation Alternate names Naamgegevens Definition A human's name with the ability to identify parts and usage. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for recieving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while recieving systems should be able to handle this one-instance approach. More specifically: Sending and recieving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the patient name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a recieving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, recieving systems SHOULD interpret the usage as the normal use. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas: `.family` = "Jongeneel-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "Jongeneel" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas" Data Type nl-core-humanname Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-core-humanname-1:if you specify a prefix for an own name then an own name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()` nl-core-humanname-2:if you specify a voorvoegsel for a partner name then a partner name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()` Examples Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "text": "Irma Jongeneel-de Haas", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma" ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] } ] } Unstructured HumanName { "text": "Irma Jongeneel-de Haas" } Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:PID-5, PID-9 rim:name cda:.patient.name hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.6 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.6 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.1 BRP:02 hcim-patient-v2.0.1-2015EN:NL-CM:0.1.6 hcim-patient-v3.0-2016EN:NL-CM:0.1.6 hcim-patient-v3.1-2017EN:NL-CM:0.1.6 hcim-payer-v1.2-2015EN:NL-CM:1.1.5 hcim-payer-v3.0-2016EN:NL-CM:1.1.5 hcim-payer-v3.1-2017EN:NL-CM:1.1.5
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.name.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameAssemblyOrder	I	0..1	ExtensionBinding	There are no (further) constraints on this element Element Id Patient.name.extension:humannameAssemblyOrder Short description Preferred display order of name parts Alternate names extensions, user content, Voorkeursvolgorde van de naamdelen. Definition A code that represents the preferred display order of the components of this human name. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Binding Human Name Assembly Order name-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.34 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.34 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.7
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.extension:humannameAssemblyOrder.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A code that represents the preferred display order of the components of a human name name-assembly-order (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data Type code Binding The use of a human name name-use (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.7, but often indicated by which field contains the name rim:unique(./use) servd:./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.name.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:implied by XPN.11 rim:./formatted hcim-payer-v1.2-2015EN:NL-CM:1.1.5 hcim-payer-v3.0-2016EN:NL-CM:1.1.5 hcim-payer-v3.1-2017EN:NL-CM:1.1.5
family	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.name.family Short description Surname Alternate names surname, Achternaam Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.1/FN.1 rim:./part[partType = FAM] servd:./FamilyName
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.name.family.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameOwnPrefix	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnPrefix Short description PrefixOwnName Alternate names extensions, user content, VoorvoegselGeslachtsnaam Definition The prefix portion (e.g. voorvoegsel) inclusive of the space between the prefix and the surname, if applicable, of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.2 rim:ENXP where Qualifiers = (VV, R) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.38 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.38 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.11
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnPrefix.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannameOwnName	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnName Short description OwnName Alternate names extensions, user content, Geslachtsnaam Definition The person’s official last name. Comments The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.3 rim:ENXP where Qualifiers = (BR) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.24 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.24 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.10
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannameOwnName.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerPrefix	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerPrefix Short description PrefixSurname Alternate names extensions, user content, VoorvoegselGeslachtsnaamPartner Definition Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.4 rim:ENXP where Qualifiers = (VV, SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.39 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.39 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.9
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerPrefix.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerName	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerName Short description LastNamePartner Alternate names extensions, user content, GeslachtsnaamPartner Definition Partner’s official last name. Comments The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.5 rim:ENXP where Qualifiers = (SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.25 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.25 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.8
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.name.family.extension:humannamePartnerName.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
given	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.name.given Short description Given Alternate names first name, middle name, Voornamen, Initialen, Roepnaam Definition Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. Comments Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier _BR_maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName. Please see the compatibility note on the containing element as well! Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.2 + XPN.3 rim:./part[partType = GIV] servd:./GivenNames hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.26 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.35 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.27 BRP:02.10 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.26 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.35 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.27 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.4 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.5 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.6
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.name.given.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
iso21090EnQualifier	I	0..1	Extension(code)	There are no (further) constraints on this element Element Id Patient.name.given.extension:iso21090EnQualifier Short description LS \| AC \| NB \| PR \| HON \| BR \| AD \| SP \| MID \| CL \| IN \| VV Alternate names extensions, user content Definition A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Comments Used to indicate additional information about the name part and how it should be used. Data Type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ENXP.qualifier
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.name.given.extension:iso21090EnQualifier.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.name.given.extension:iso21090EnQualifier.value[x]:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type name-part-qualifier (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
prefix	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.5 rim:./part[partType = PFX] servd:./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN/4 rim:./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XPN.13 + XPN.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate
telecom	Σ I	0..*	nl-core-contactpoint	Element Id Patient.telecom Short description ContactInformation Alternate names Contactgegevens Definition A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data Type nl-core-contactpoint Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Examples Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number. { "system": "phone", "value": "+31611234567", "use": "work" } Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number. { "system": "phone", "value": "+31611234567", "use": "mobile" } Primary Home Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "home" } Temporary Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "temp" } Primary Work Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "work" } Primary Home Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "home" } Temporary Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "temp" } Primary Work Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "work" } Primary Home Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "home" } Temporary Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "temp" } Primary Work Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "work" } Primary Home Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "home" } Temporary Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "temp" } Primary Work Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "work" } Private email address { "system": "email", "value": "giesput@myweb.nl", "use": "home" } Work email address { "system": "email", "value": "example@workplace.nl", "use": "work" } Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:PID-13, PID-14, PID-40 rim:telecom cda:.telecom hcim-contactinformation-v2.0.1-2015EN:NL-CM:0.1.5 hcim-contactinformation-v3.0-2016EN:NL-CM:0.1.5 hcim-contactinformation-v1.0-2017EN:NL-CM:20.6.1 hcim-patient-v2.0.1-2015EN:NL-CM:0.1.5 hcim-patient-v3.0-2016EN:NL-CM:0.1.5 hcim-patient-v3.1-2017EN:NL-CM:0.1.5 hcim-payer-v1.2-2015EN:NL-CM:1.1.12 hcim-payer-v3.0-2016EN:NL-CM:1.1.12 hcim-payer-v3.1-2017EN:NL-CM:1.1.12
gender	Σ	0..1	codeBinding	Element Id Patient.gender Short description Gender Alternate names Geslacht Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. Comments The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error. Data Type code Binding The gender of a person used for administrative purposes. administrative-gender (required) Permitted Values GeslachtCodelijst-to-AdministrativeGender Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-8 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda:.patient.administrativeGenderCode hcim-patient-v2.0.1-2015EN:NL-CM:0.1.9 hcim-patient-v3.0-2016EN:NL-CM:0.1.9 hcim-patient-v3.1-2017EN:NL-CM:0.1.9
extension	I	0..*	Extension	Element Id Patient.gender.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
GeslachtCodelijst	I	0..1	Extension(CodeableConcept)	Element Id Patient.gender.extension:GeslachtCodelijst Short description Gender Alternate names extensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Geslacht Definition Patient’s administrative gender. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.gender.extension:GeslachtCodelijst.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/code-specification Mappings rim:n/a rim:N/A
valueCodeableConcept		1..1	CodeableConceptBinding	Element Id Patient.gender.extension:GeslachtCodelijst.valueCodeableConcept:valueCodeableConcept Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type CodeableConcept Binding GeslachtCodelijst GeslachtCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
birthDate	Σ	0..1	date	Element Id Patient.birthDate Short description Patients date of birth. The date of birth is mandatory for a patient. An incomplete date, e.g. only year or only year + month, is permitted. Alternate names Geboortedatum Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems). Data Type date Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-7 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda:.patient.birthTime loinc:21112-8 hcim-patient-v2.0.1-2015EN:NL-CM:0.1.10 hcim-patient-v3.0-2016EN:NL-CM:0.1.10 hcim-patient-v3.1-2017EN:NL-CM:0.1.10
deceased[x]	Σ ?!	0..1		Element Id Patient.deceased[x] Short description DeathIndicator/DateOfDeath Alternate names Overlijdensindicator/DatumOverlijden Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-30 (bool) and PID-29 (datetime) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda:n/a hcim-patient-v2.0.1-2015EN:NL-CM:0.1.32 hcim-patient-v3.0-2016EN:NL-CM:0.1.32 hcim-patient-v3.1-2017EN:NL-CM:0.1.32 hcim-patient-v2.0.1-2015EN:NL-CM:0.1.33 hcim-patient-v3.0-2016EN:NL-CM:0.1.33 hcim-patient-v3.1-2017EN:NL-CM:0.1.33
deceasedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data Type dateTime
address	Σ I	0..*	nl-core-address	Element Id Patient.address Short description AddressInformation Alternate names AdresInformatie, Adresgegevens Definition This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The HCIM code itself should also be included using the AddressType extension. `\| HCIM \| .ext:AddressType \| .ext:official \| .use \| .type \| \|-----------------------------------\|------------------\|---------------\|------\|----------\| \| Postal Address/Postadres \| PST \| \| \| postal \| \| Primary Home/Officieel adres \| HP \| true \| home \| \| \| Visit Address/Woon-/verblijfadres \| PHYS \| \| home \| physical \| \| Temporary Address/Tijdelijk adres \| TMP \| \| temp \| \| \| Work Place/Werkadres \| WP \| \| work \| \| \| Vacation Home/Vakantie adres \| HV \| \| temp \| \|` If Address.type is "both" then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Note: address is for postal addresses, not physical locations. Data Type nl-core-address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-streetname-if-official-and-other-line-parts:Address.streetName in an official address SHALL have a value if one of houseNumber\|buildingNumberSuffix\|additionalLocator has a value (extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not())) Examples Example of a Vacation Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HV", "display": "Vakantie adres" } ] } } ], "use": "temp", "line": [ "Binnenkant 12A Hoog" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "12" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString": "A" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString": "Hoog" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1000AA", "country": "NLD" } Example of a Primary Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HP", "display": "Officieel adres" } ] } }, { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": true } ], "use": "home", "line": [ "Binnenkant to 10" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString": "to" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "10" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1001AA", "country": "NLD" } Mappings rim:n/a v2:XAD rim:AD servd:Address v2:PID-11 rim:addr cda:.addr hcim-address-v2.0.1-2015EN:NL-CM:0.1.4 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.4 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.1 hcim-patient-v2.0.1-2015EN:NL-CM:0.1.4 hcim-patient-v3.0-2016EN:NL-CM:0.1.4 hcim-patient-v3.1-2017EN:NL-CM:0.1.4 hcim-payer-v1.2-2015EN:NL-CM:1.1.17 hcim-payer-v3.0-2016EN:NL-CM:1.1.17 hcim-payer-v3.1-2017EN:NL-CM:1.1.17
maritalStatus		0..1	CodeableConceptBinding	Element Id Patient.maritalStatus Short description MaritalStatus Alternate names BurgerlijkeStaat Definition This field contains a patient's most recent marital (civil) status. A person’s marital status according to the terms and definition in the Dutch civil code. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The domestic partnership status of a person. BurgerlijkeStaatCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-16 rim:player[classCode=PSN]/maritalStatusCode cda:.patient.maritalStatusCode hcim-maritalstatus-v1.2.1-2015EN:NL-CM:7.9.2 hcim-maritalstatus-v3.0-2016EN:NL-CM:7.9.2 hcim-maritalstatus-v3.0-2017EN:NL-CM:7.9.2 hcim-familysituation-v1.0-2015EN:NL-CM:7.13.7 hcim-familysituation-v3.0-2016EN:NL-CM:7.13.7 hcim-familysituation-v3.0-2017EN:NL-CM:7.13.7
multipleBirth[x]		0..1		Element Id Patient.multipleBirth[x] Short description MultipleBirthIndicator Alternate names Meerlingindicator Definition Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-24 (bool), PID-25 (integer) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda:n/a hcim-patient-v2.0.1-2015EN:NL-CM:0.1.31 hcim-patient-v3.0-2016EN:NL-CM:0.1.31 hcim-patient-v3.1-2017EN:NL-CM:0.1.31
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data Type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data Type integer
photo	I	0..*	Attachment	There are no (further) constraints on this element Element Id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Data Type Attachment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` att-1:It the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim:n/a v2:ED/RP rim:ED v2:OBX-5 - needs a profile rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda:n/a
contact	I	0..*	BackboneElement	Element Id Patient.contact Short description ContactPerson Alternate names Contactpersoon Definition Contacts are related persons in some way, but not all related persons are contacts. The HCIM ContactPerson is designed to deal with both related persons and contacts. An HCIM ContactPerson who is a contact, is expected to have an NL-CM:3.1.2 Role primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon'). See Patient.contact.relationship in slice 'role'. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` pat-1:SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim:n/a rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda:n/a hcim-contactperson-v1.2-2015EN:NL-CM:3.1.1 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.1 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.1
relationship		0..*	CodeableConceptBinding	Element Id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) Binding The nature of the relationship between a patient and a contact person for that patient. HL7 v2 Value Set 0131 (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:NK1-7, NK1-3 rim:code cda:n/a
relationship		0..*	CodeableConceptBinding	Element Id Patient.contact.relationship:relationship Short description Relationship Alternate names Relatie Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. RelatieCodelijst (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:NK1-7, NK1-3 rim:code cda:n/a hcim-contactperson-v1.2-2015EN:NL-CM:3.1.3 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.3 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.3
role		0..*	CodeableConceptBinding	Element Id Patient.contact.relationship:role Short description Role Alternate names Rol Definition Expectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon') Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. RolCodelijst (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:NK1-7, NK1-3 rim:code cda:n/a hcim-contactperson-v1.2-2015EN:NL-CM:3.1.2 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.2 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.2
name	I	0..1	nl-core-humanname	Element Id Patient.contact.name Short description NameInformation Alternate names Naamgegevens Definition A human's name with the ability to identify parts and usage. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for recieving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while recieving systems should be able to handle this one-instance approach. More specifically: Sending and recieving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the patient name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a recieving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, recieving systems SHOULD interpret the usage as the normal use. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas: `.family` = "Jongeneel-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "Jongeneel" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas" Data Type nl-core-humanname Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-core-humanname-1:if you specify a prefix for an own name then an own name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()` nl-core-humanname-2:if you specify a voorvoegsel for a partner name then a partner name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()` Examples Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "text": "Irma Jongeneel-de Haas", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma" ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] } ] } Unstructured HumanName { "text": "Irma Jongeneel-de Haas" } Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:NK1-2 rim:name cda:n/a hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.6 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.6 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.1 BRP:02 hcim-contactperson-v1.2-2015EN:NL-CM:3.1.4 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.4 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.4
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameAssemblyOrder	I	0..1	ExtensionBinding	There are no (further) constraints on this element Element Id Patient.contact.name.extension:humannameAssemblyOrder Short description Preferred display order of name parts Alternate names extensions, user content, Voorkeursvolgorde van de naamdelen. Definition A code that represents the preferred display order of the components of this human name. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Binding Human Name Assembly Order name-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.34 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.34 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.7
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.extension:humannameAssemblyOrder.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.contact.name.extension:humannameAssemblyOrder.valueCode:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A code that represents the preferred display order of the components of a human name name-assembly-order (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.contact.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data Type code Binding The use of a human name name-use (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.7, but often indicated by which field contains the name rim:unique(./use) servd:./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:implied by XPN.11 rim:./formatted hcim-payer-v1.2-2015EN:NL-CM:1.1.5 hcim-payer-v3.0-2016EN:NL-CM:1.1.5 hcim-payer-v3.1-2017EN:NL-CM:1.1.5
family	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.family Short description Surname Alternate names surname, Achternaam Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.1/FN.1 rim:./part[partType = FAM] servd:./FamilyName
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameOwnPrefix	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnPrefix Short description PrefixOwnName Alternate names extensions, user content, VoorvoegselGeslachtsnaam Definition The prefix portion (e.g. voorvoegsel) inclusive of the space between the prefix and the surname, if applicable, of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.2 rim:ENXP where Qualifiers = (VV, R) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.38 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.38 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.11
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnPrefix.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannameOwnName	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnName Short description OwnName Alternate names extensions, user content, Geslachtsnaam Definition The person’s official last name. Comments The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.3 rim:ENXP where Qualifiers = (BR) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.24 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.24 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.10
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannameOwnName.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerPrefix	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerPrefix Short description PrefixSurname Alternate names extensions, user content, VoorvoegselGeslachtsnaamPartner Definition Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.4 rim:ENXP where Qualifiers = (VV, SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.39 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.39 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.9
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerPrefix.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerName	I	0..1	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerName Short description LastNamePartner Alternate names extensions, user content, GeslachtsnaamPartner Definition Partner’s official last name. Comments The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.5 rim:ENXP where Qualifiers = (SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.25 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.25 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.8
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.contact.name.family.extension:humannamePartnerName.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
given	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.contact.name.given Short description Given Alternate names first name, middle name, Voornamen, Initialen, Roepnaam Definition Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. Comments Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier _BR_maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName. Please see the compatibility note on the containing element as well! Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.2 + XPN.3 rim:./part[partType = GIV] servd:./GivenNames hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.26 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.35 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.27 BRP:02.10 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.26 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.35 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.27 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.4 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.5 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.6
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.contact.name.given.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
iso21090EnQualifier	I	0..1	Extension(code)	There are no (further) constraints on this element Element Id Patient.contact.name.given.extension:iso21090EnQualifier Short description LS \| AC \| NB \| PR \| HON \| BR \| AD \| SP \| MID \| CL \| IN \| VV Alternate names extensions, user content Definition A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Comments Used to indicate additional information about the name part and how it should be used. Data Type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ENXP.qualifier
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.contact.name.given.extension:iso21090EnQualifier.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.contact.name.given.extension:iso21090EnQualifier.value[x]:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type name-part-qualifier (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
prefix	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.contact.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.5 rim:./part[partType = PFX] servd:./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.contact.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN/4 rim:./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Patient.contact.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XPN.13 + XPN.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate
telecom	I	0..*	nl-core-contactpoint	Element Id Patient.contact.telecom Short description ContactInformation Alternate names Contactgegevens Definition Contact information includes a person's telephone numbers and email addresses. This datatype defines a common basis for expressing all contact information around the world, but adds extensions to express Dutch contacts specifically, according to the HCIM ContactInformation (v1.0, 2017). A Dutch ContactPoint still is a proper FHIR ContactPoint, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. The table below explains how the HCIM concepts are mapped to the various FHIR elements. The HCIM code itself should also be included using the TelecomType extension. \| HCIM \| .ext:TelecomType \| .system \| .use \| \|----------------------------------------------------\|------------------\|---------\|--------\| \| Primary Home Land Line \| LL \| phone \| home \| \| Temporary Land Line \| LL \| phone \| temp \| \| Primary Work Land Line \| LL \| phone \| work \| \| \| \| \| \| \| Primary Home Fax \| FAX \| fax \| home \| \| Temporary Fax \| FAX \| fax \| temp \| \| Primary Work Fax \| FAX \| fax \| work \| \| \| \| \| \| \| Primary Home Mobile Phone \| MC \| phone \| home \| \| Temporary Mobile Phone \| MC \| phone \| temp \| \| Primary Work Mobile Phone \| MC \| phone \| work \| \| \| \| \| \| \| Primary Home Pager \| PG \| pager \| home \| \| Temporary Pager \| PG \| pager \| temp \| \| Primary Work Pager \| PG \| pager \| work \| \| \| \| \| \| \| Private email address \| \| email \| home \| \| Work email address \| \| email \| work \| \| \| \| \| \| \| Mobile phone number undetermined private/business \| \| phone \| mobile \| Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Telecommunication data details (phone/email) is physically modeled in the HCIM Patient, which is why the telecommunication mappings appear to be coming from the HCIM Patient instead of the HCIM ContactPerson Data Type nl-core-contactpoint Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Examples Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number. { "system": "phone", "value": "+31611234567", "use": "work" } Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number. { "system": "phone", "value": "+31611234567", "use": "mobile" } Primary Home Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "home" } Temporary Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "temp" } Primary Work Land Line { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "LL", "display": "Land Line" } ] } } ], "system": "phone", "value": "...", "use": "work" } Primary Home Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "home" } Temporary Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "temp" } Primary Work Fax { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code": "FAX", "display": "Fax" } ] } } ], "system": "fax", "value": "...", "use": "work" } Primary Home Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "home" } Temporary Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "temp" } Primary Work Mobile Phone { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "MC", "display": "Mobile Phone" } ] } } ], "system": "phone", "value": "...", "use": "work" } Primary Home Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "home" } Temporary Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "temp" } Primary Work Pager { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "PG", "display": "Pager" } ] } } ], "system": "pager", "value": "...", "use": "work" } Private email address { "system": "email", "value": "giesput@myweb.nl", "use": "home" } Work email address { "system": "email", "value": "example@workplace.nl", "use": "work" } Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:NK1-5, NK1-6, NK1-40 rim:telecom cda:n/a hcim-contactinformation-v2.0.1-2015EN:NL-CM:0.1.5 hcim-contactinformation-v3.0-2016EN:NL-CM:0.1.5 hcim-contactinformation-v1.0-2017EN:NL-CM:20.6.1 hcim-contactperson-v1.2-2015EN:NL-CM:3.1.6 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.6 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.6
address	I	0..1	nl-core-address	Element Id Patient.contact.address Short description AddressInformation Alternate names AdresInformatie, Adresgegevens Definition This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The HCIM code itself should also be included using the AddressType extension. `\| HCIM \| .ext:AddressType \| .ext:official \| .use \| .type \| \|-----------------------------------\|------------------\|---------------\|------\|----------\| \| Postal Address/Postadres \| PST \| \| \| postal \| \| Primary Home/Officieel adres \| HP \| true \| home \| \| \| Visit Address/Woon-/verblijfadres \| PHYS \| \| home \| physical \| \| Temporary Address/Tijdelijk adres \| TMP \| \| temp \| \| \| Work Place/Werkadres \| WP \| \| work \| \| \| Vacation Home/Vakantie adres \| HV \| \| temp \| \|` If Address.type is "both" then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is for postal addresses, not physical locations. Data Type nl-core-address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-streetname-if-official-and-other-line-parts:Address.streetName in an official address SHALL have a value if one of houseNumber\|buildingNumberSuffix\|additionalLocator has a value (extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not())) Examples Example of a Vacation Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HV", "display": "Vakantie adres" } ] } } ], "use": "temp", "line": [ "Binnenkant 12A Hoog" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "12" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString": "A" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString": "Hoog" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1000AA", "country": "NLD" } Example of a Primary Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HP", "display": "Officieel adres" } ] } }, { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": true } ], "use": "home", "line": [ "Binnenkant to 10" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString": "to" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "10" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1001AA", "country": "NLD" } Mappings rim:n/a v2:XAD rim:AD servd:Address v2:NK1-4 rim:addr cda:n/a hcim-address-v2.0.1-2015EN:NL-CM:0.1.4 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.4 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.1 hcim-contactperson-v1.2-2015EN:NL-CM:3.1.5 hcim-contactperson-v3.0-2016EN:NL-CM:3.1.5 hcim-contactperson-v3.1-2017EN:NL-CM:3.1.5
gender		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding The gender of a person used for administrative purposes. administrative-gender (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:NK1-15 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda:n/a
organization	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim:scoper cda:n/a
period	I	0..1	Period	There are no (further) constraints on this element Element Id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim:effectiveTime cda:n/a
animal	Σ ?!	0..1	BackboneElement	There are no (further) constraints on this element Element Id Patient.animal Short description This patient is known to be an animal (non-human) Definition This patient is known to be an animal. Requirements Many clinical systems are extended to care for animal patients as well as human. Comments The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal). Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:player[classCode=ANM] cda:n/a
species	Σ	1..1	CodeableConcept	There are no (further) constraints on this element Element Id Patient.animal.species Short description E.g. Dog, Cow Definition Identifies the high level taxonomic categorization of the kind of animal. Requirements Need to know what kind of animal. Comments If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.). Data Type CodeableConcept Binding The species of an animal. animal-species (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-35 rim:code cda:n/a
breed	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id Patient.animal.breed Short description E.g. Poodle, Angus Definition Identifies the detailed categorization of the kind of animal. Requirements May need to know the specific kind within the species. Comments Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type. Data Type CodeableConcept Binding The breed of an animal. animal-breeds (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-37 rim:playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code cda:n/a
genderStatus	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id Patient.animal.genderStatus Short description E.g. Neutered, Intact Definition Indicates the current state of the animal's reproductive organs. Requirements Gender status can affect housing and animal behavior. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The state of the animal's reproductive organs. animal-genderstatus (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:N/A rim:genderStatusCode cda:n/a
communication		0..*	BackboneElement	Element Id Patient.communication Short description A list of Languages which may be used to communicate with the patient about his or her health Alternate names Taalvaardigheid Definition Languages which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:LanguageCommunication cda:patient.languageCommunication hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.1
extension	I	0..*	Extension	Element Id Patient.communication.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
languageProficiency	I	0..*	Extension(Complex)	Element Id Patient.communication.extension:languageProficiency Short description Proficiency level of the communication Alternate names extensions, user content Definition Proficiency level of the communication. Comments The HCIM concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captuperd using a mocked offical HL7 core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping: LanguaneControlListening maps to code 'RSP' (Received spoken) LanguageControlReading maps to code 'RWR' (Received written) LanguageControlSpeaking maps to code 'ESP' (Expressed spoken) Data Type Extension(Complex) Extension URL http://nictiz.nl/fhir/StructureDefinition/patient-proficiency Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.6 hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.7 hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.8
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
type	I	1..1	Extension	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.extension:type Short description The proficiency type of the communication Alternate names extensions, user content Definition What type of communication for the proficiency (spoken, written, etc.). Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.extension:type.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value type Mappings rim:n/a rim:N/A
valueCoding		1..1	CodingBinding	Element Id Patient.communication.extension:languageProficiency.extension:type.valueCoding:valueCoding Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type Coding Binding The proficiency type for the communication. TaalvaardigheidBegrijpenCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
level	I	1..1	Extension	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.extension:level Short description The proficiency level of the communication Alternate names extensions, user content Definition How well the patient can communicate this communication (good, poor, etc.). Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.extension:level.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value level Mappings rim:n/a rim:N/A
valueCoding		1..1	CodingBinding	Element Id Patient.communication.extension:languageProficiency.extension:level.valueCoding:valueCoding Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type Coding Binding The proficiency level for the communication. TaalvaardigheidBegrijpenCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/patient-proficiency Mappings rim:n/a rim:N/A
value[x]		0..0		There are no (further) constraints on this element Element Id Patient.communication.extension:languageProficiency.value[x] Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
comment	I	0..*	Extension(string)	Element Id Patient.communication.extension:comment Short description Comment Alternate names extensions, user content, Toelichting Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL http://nictiz.nl/fhir/StructureDefinition/Comment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.5
language		1..1	CodeableConceptBinding	Element Id Patient.communication.language Short description CommunicationLanguage Alternate names CommunicatieTaal Definition The language of communication. The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The FHIR valueset http://hl7.org/fhir/valueset-languages.html is used instead of the ZIB valueset CommunicationLanguageCodelist. The FHIR valueset uses the codesystem urn:ietf:bcp:47 which includes the ISO-639-2 alpha codesystem used by the ZIB valueset. Data Type CodeableConcept Binding A human language. languages (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-15, LAN-2 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda:.languageCode hcim-languageproficiency-v3.1-2017EN:NL-CM:7.12.3
preferred		0..1	boolean	There are no (further) constraints on this element Element Id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-15 rim:preferenceInd cda:.preferenceInd
generalPractitioner	I	0..1	Reference(nl-core-organization \| nl-core-practitioner)	Element Id Patient.generalPractitioner Short description GeneralPractitioner Alternate names careProvider, Huisarts Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Data Type Reference(nl-core-organization \| nl-core-practitioner) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PD1-4 rim:subjectOf.CareEvent.performer.AssignedEntity cda:n/a hcim-healthcareprovider-v1.2-2015EN:NL-CM:17.2.1 hcim-healthcareprovider-v3.0-2016EN:NL-CM:17.2.1 hcim-healthcareprovider-v3.1.1-2017EN:NL-CM:17.2.1 hcim-healthprofessional-v1.2.1-2015EN:NL-CM:17.1.1 hcim-healthprofessional-v3.0-2016EN:NL-CM:17.1.1 hcim-healthprofessional-v3.2-2017EN:NL-CM:17.1.1
extension	I	0..*	Extension	Element Id Patient.generalPractitioner.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
practitionerRole	I	0..1	Extension(Reference(nl-core-practitionerrole))	Element Id Patient.generalPractitioner.extension:practitionerRole Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Reference(nl-core-practitionerrole)) Extension URL http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
reference	Σ I	0..1	string	There are no (further) constraints on this element Element Id Patient.generalPractitioner.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element Id Patient.generalPractitioner.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier rim:.identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.generalPractitioner.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
managingOrganization	Σ I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:scoper cda:.providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element Id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple usecases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:outboundLink cda:n/a
other	Σ I	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PID-3, MRG-1 rim:id cda:n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso - type of link Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding The type of link between this patient resource and another patient resource. link-type (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:typeCode cda:n/a

The next example shows the Dutch national profile for the data type HumanName. The family name has some extensions to include the prefix that is commonly used in a Dutch family name.

HumanName	I		HumanName	Element Id HumanName Short description Name of a human - parts and usage Definition A human's name with the ability to identify parts and usage. Comments Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for recieving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while recieving systems should be able to handle this one-instance approach. More specifically: Sending and recieving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the patient name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a recieving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, recieving systems SHOULD interpret the usage as the normal use. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas: `.family` = "Jongeneel-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "Jongeneel" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas" Data Type HumanName Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-core-humanname-1:if you specify a prefix for an own name then an own name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()` nl-core-humanname-2:if you specify a voorvoegsel for a partner name then a partner name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()` Examples Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "text": "Irma Jongeneel-de Haas", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma" ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] } ] } Unstructured HumanName { "text": "Irma Jongeneel-de Haas" } Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.6 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.6 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.1 BRP:02
extension	I	0..*	Extension	Element Id HumanName.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameAssemblyOrder	I	0..1	ExtensionBinding	Element Id HumanName.extension:humannameAssemblyOrder Short description Preferred display order of name parts Alternate names extensions, user content, Voorkeursvolgorde van de naamdelen. Definition A code that represents the preferred display order of the components of this human name. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Binding Human Name Assembly Order name-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.34 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.34 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.7
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.extension:humannameAssemblyOrder.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id HumanName.extension:humannameAssemblyOrder.valueCode:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A code that represents the preferred display order of the components of a human name name-assembly-order (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id HumanName.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data Type code Binding The use of a human name name-use (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.7, but often indicated by which field contains the name rim:unique(./use) servd:./NamePurpose
text	Σ	0..1	string	Element Id HumanName.text Short description Text representation of the full name Definition A full text representation of the name. Requirements A renderable, unencoded form. Comments Can provide both a text representation and structured parts. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:implied by XPN.11 rim:./formatted hcim-payer-v1.2-2015EN:NL-CM:1.1.5 hcim-payer-v3.0-2016EN:NL-CM:1.1.5 hcim-payer-v3.1-2017EN:NL-CM:1.1.5
family	Σ	0..1	string	Element Id HumanName.family Short description Surname Alternate names surname, Achternaam Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.1/FN.1 rim:./part[partType = FAM] servd:./FamilyName
extension	I	0..*	Extension	Element Id HumanName.family.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
humannameOwnPrefix	I	0..1	Extension	Element Id HumanName.family.extension:humannameOwnPrefix Short description PrefixOwnName Alternate names extensions, user content, VoorvoegselGeslachtsnaam Definition The prefix portion (e.g. voorvoegsel) inclusive of the space between the prefix and the surname, if applicable, of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.2 rim:ENXP where Qualifiers = (VV, R) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.38 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.38 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.11
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.family.extension:humannameOwnPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id HumanName.family.extension:humannameOwnPrefix.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannameOwnName	I	0..1	Extension	Element Id HumanName.family.extension:humannameOwnName Short description OwnName Alternate names extensions, user content, Geslachtsnaam Definition The person’s official last name. Comments The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.3 rim:ENXP where Qualifiers = (BR) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.24 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.24 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.10
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.family.extension:humannameOwnName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id HumanName.family.extension:humannameOwnName.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerPrefix	I	0..1	Extension	Element Id HumanName.family.extension:humannamePartnerPrefix Short description PrefixSurname Alternate names extensions, user content, VoorvoegselGeslachtsnaamPartner Definition Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. Comments An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component. Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.4 rim:ENXP where Qualifiers = (VV, SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.39 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.39 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.9
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.family.extension:humannamePartnerPrefix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id HumanName.family.extension:humannamePartnerPrefix.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
humannamePartnerName	I	0..1	Extension	Element Id HumanName.family.extension:humannamePartnerName Short description LastNamePartner Alternate names extensions, user content, GeslachtsnaamPartner Definition Partner’s official last name. Comments The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name". Data Type Extension Extension URL http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:FN.5 rim:ENXP where Qualifiers = (SP) hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.25 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.25 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.8
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.family.extension:humannamePartnerName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-name Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id HumanName.family.extension:humannamePartnerName.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
given	Σ	0..*	string	Element Id HumanName.given Short description Given Alternate names first name, middle name, Voornamen, Initialen, Roepnaam Definition Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. Comments Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier _BR_maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName. Please see the compatibility note on the containing element as well! Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.2 + XPN.3 rim:./part[partType = GIV] servd:./GivenNames hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.26 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.35 hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.27 BRP:02.10 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.26 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.35 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.27 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.4 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.5 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.6
extension	I	0..*	Extension	Element Id HumanName.given.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
iso21090EnQualifier	I	0..1	Extension(code)	Element Id HumanName.given.extension:iso21090EnQualifier Short description LS \| AC \| NB \| PR \| HON \| BR \| AD \| SP \| MID \| CL \| IN \| VV Alternate names extensions, user content Definition A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Comments Used to indicate additional information about the name part and how it should be used. Data Type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ENXP.qualifier
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id HumanName.given.extension:iso21090EnQualifier.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Mappings rim:n/a rim:N/A
valueCode		0..1	codeBinding	There are no (further) constraints on this element Element Id HumanName.given.extension:iso21090EnQualifier.valueCode:valueCode Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type code Binding A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type name-part-qualifier (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
prefix	Σ	0..*	string	There are no (further) constraints on this element Element Id HumanName.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN.5 rim:./part[partType = PFX] servd:./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element Id HumanName.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN/4 rim:./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id HumanName.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XPN.13 + XPN.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate

See the xml code below for an example of a Dutch patient called "Piet de Bakker".

<Patient xmlns="http://hl7.org/fhir">
    <name>
      <given value="Piet"/>
      <family value="de Bakker">
        <extension url= "http://hl7.org/fhir/StructureDefinition/humanname-own-prefix">
            <valueString="de"/>
        <extension>
        <extension url= "http://hl7.org/fhir/StructureDefinition/humanname-own-name">
            <valueString="Bakker"/>
        <extension>
      </family>
    </name>
</Patient>

Exercise

In this exercise you will build your first profile. Start by reading the case description. Here below are a couple of links that you may find useful during this exercise:

Download Forge
FHIR Resourcelist: http://hl7.org/fhir/resourcelist.html
FHIR Data types: http://hl7.org/fhir/datatypes.html

Case description

A patient has at least 1 family name and 1 given name
Date of birth is mandatory
Gender is mandatory
The hospital wants to record if a patient is deceased or not, not the actual dateTime

Steps to follow

Start Forge and build a new profile. Choose the basis resource that is best fit for exchanging administrative patient data. Take a look at the FHIR resource list.
Give the profile a valid, unique URL (tab ‘Properties’), for example: http://example.org/fhir/StructureDefinition/HospitalXPatient
Complement the remaining metadata in the profile (name, description, etc.).
Set the constraints according to the requirements of the hospital.

Feedback

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