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:
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.
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.
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.
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 |
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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.
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.
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.
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:
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.
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.
Here below are examples of customers that we helped building profiles.
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:
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:
Patient | Patient | Element IdPatient Patient Alternate namesSubjectOfCare Client Resident, Patiënt DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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extension | 0..* | Extension | Element IdPatient.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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. 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. Unordered, Open, by url(Value) Constraints
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preferredPharmacy | 0..1 | Extension(Reference(nl-core-organization)) | Element IdPatient.extension:preferredPharmacy References a patient's preferered pharmacy Alternate namesextensions, user content, Verwijst naar de voorkeursapotheek van de patiënt DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-organization)) Extension URLhttp://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy Constraints
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nationality | 0..* | Extension | Element IdPatient.extension:nationality Nationality Alternate namesextensions, user content, Nationaliteit DefinitionThe nationality of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-nationality Constraints
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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code | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension:code Nationality Code Alternate namesextensions, user content DefinitionCode representing nationality of patient. 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension:code.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
code
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valueCodeableConcept | 0..1 | CodeableConceptBinding | Element IdPatient.extension:nationality.extension:code.valueCodeableConcept:valueCodeableConcept Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded NationaliteitCodelijst (extensible) Constraints
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period | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension:period Nationality Period Alternate namesextensions, user content DefinitionPeriod when nationality was effective. 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension:period.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
period
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valuePeriod | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.extension:nationality.extension:period.valuePeriod:valuePeriod Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:nationality.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/patient-nationality
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value[x] | 0..0 | There are no (further) constraints on this element Element IdPatient.extension:nationality.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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legalStatus | 0..2 | Extension(CodeableConcept) | Element IdPatient.extension:legalStatus legalStatus Alternate namesextensions, user content DefinitionThe 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. 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. http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element IdPatient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept LegalStatus Alternate namesJuridischeStatus DefinitionThe 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. A stream of bytes, base64 encoded JuridischeStatusCodelijst (extensible) Constraints
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coding | Σ | 1..* | Coding | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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.
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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lifeStance | 0..* | Extension(CodeableConcept) | Element IdPatient.extension:lifeStance Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element IdPatient.extension:lifeStance.valueCodeableConcept:valueCodeableConcept LifeStance Alternate namesLevensovertuiging DefinitionPatient’s life stance and/or religion. A stream of bytes, base64 encoded LevensovertuigingCodelijst (preferred) Constraints
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coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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.
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:lifeStance.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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identifier | Σ | 0..* | Identifier | Element IdPatient.identifier PatientIdentificationNumber Alternate namesIdentificatienummer DefinitionThe 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). Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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BSN | Σ | 0..1 | Identifier | Element IdPatient.identifier:BSN BSN Alternate namesBSN DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:BSN.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. 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.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:BSN.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
http://fhir.nl/fhir/NamingSystem/bsn
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value | Σ | 1..1 | string | Element IdPatient.identifier:BSN.value BSN (Burgerservicenummer (Dutch person identification number)) Alternate namesBSN DefinitionBurgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare. 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.
General 123456 Example of a burgerservicenummer 123456782 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:BSN.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:BSN.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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active | Σ ?! | 0..1 | boolean | Element IdPatient.active Whether this patient's record is in active use DefinitionThis 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. Need to be able to mark a patient record as not to be used because it was created in error. 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.
true
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name | Σ | 0..* | nl-core-humanname | Element IdPatient.name NameInformation Alternate namesNaamgegevens DefinitionA human's name with the ability to identify parts and usage. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. 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. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas"
Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "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", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Unstructured HumanName { "use": "official", "text": "Irma Jongeneel-de Haas" } Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.name.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameAssemblyOrder | 0..1 | ExtensionBinding | There are no (further) constraints on this element Element IdPatient.name.extension:humannameAssemblyOrder Preferred display order of name parts Alternate namesextensions, user content, Voorkeursvolgorde van de naamdelen. DefinitionA code that represents the preferred display order of the components of this human name. 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. http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Bindingname-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.extension:humannameAssemblyOrder.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-assembly-order
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valueCode | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.name.extension:humannameAssemblyOrder.valueCode:valueCode Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded name-assembly-order (required) Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.name.use usual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name. Allows the appropriate name for a particular context of use to be selected from among a set of names. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.text Text representation of the full name DefinitionA full text representation of the name. A renderable, unencoded form. Can provide both a text representation and structured parts.
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family | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family Surname Alternate namessurname, Achternaam DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.name.family.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameOwnPrefix | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnPrefix PrefixOwnName Alternate namesextensions, user content, VoorvoegselGeslachtsnaam DefinitionThe 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. 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. http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnPrefix.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannameOwnName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnName OwnName Alternate namesextensions, user content, Geslachtsnaam DefinitionThe person’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannameOwnName.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerPrefix | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerPrefix PrefixSurname Alternate namesextensions, user content, VoorvoegselGeslachtsnaamPartner DefinitionVoorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. 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. http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerPrefix.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerName LastNamePartner Alternate namesextensions, user content, GeslachtsnaamPartner DefinitionPartner’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family.extension:humannamePartnerName.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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given | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.given Given Alternate namesfirst name, middle name, Voornamen, Initialen, Roepnaam DefinitionNote that in order to mark the type of a given name, that you use the FHIR standard extension for ISO 21090 EN Qualifiers. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the Zib for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier 'BR' maps to the Zib concept FirstNames, 'IN' maps to Initials and 'CL' to GivenName.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.name.given.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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iso21090EnQualifier | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.name.given.extension:iso21090EnQualifier LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV Alternate namesextensions, user content DefinitionA set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Used to indicate additional information about the name part and how it should be used. http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.name.given.extension:iso21090EnQualifier.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
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valueCode | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.name.given.extension:iso21090EnQualifier.value[x]:valueCode Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded name-part-qualifier (required) Constraints
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings may not exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.suffix Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings may not exceed 1MB in size
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.name.period Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. 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.
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telecom | Σ | 0..* | nl-core-contactpoint | Element IdPatient.telecom ContactInformation Alternate namesContactgegevens DefinitionA contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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).
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
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gender | Σ | 0..1 | codeBinding | Element IdPatient.gender Gender Alternate namesGeslacht DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. 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. administrative-gender (required) Permitted Values GeslachtCodelijst-to-AdministrativeGender Constraints
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extension | 0..* | Extension | Element IdPatient.gender.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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GeslachtCodelijst | 0..1 | Extension(CodeableConcept) | Element IdPatient.gender.extension:GeslachtCodelijst Gender Alternate namesextensions, 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 DefinitionPatient’s administrative gender. 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. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.gender.extension:GeslachtCodelijst.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element IdPatient.gender.extension:GeslachtCodelijst.valueCodeableConcept:valueCodeableConcept Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded GeslachtCodelijst (extensible) Constraints
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birthDate | Σ | 0..1 | date | Element IdPatient.birthDate 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 namesGeboortedatum DefinitionThe date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems).
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deceased[x] | Σ ?! | 0..1 | Element IdPatient.deceased[x] DeathIndicator/DateOfDeath Alternate namesOverlijdensindicator/DatumOverlijden DefinitionIndicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. 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.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
address | Σ | 0..* | nl-core-address | Element IdPatient.address AddressInformation Alternate namesAdresInformatie, Adresgegevens DefinitionThis 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.
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. May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Note: address is for postal addresses, not physical locations.
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
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maritalStatus | 0..1 | CodeableConceptBinding | Element IdPatient.maritalStatus MaritalStatus Alternate namesBurgerlijkeStaat DefinitionThis 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. Most, if not all systems capture it. 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. BurgerlijkeStaatCodelijst (extensible) Constraints
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multipleBirth[x] | 0..1 | Element IdPatient.multipleBirth[x] MultipleBirthIndicator Alternate namesMeerlingindicator DefinitionIndicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in 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).
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||
photo | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment".
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contact | 0..* | BackboneElement | Element IdPatient.contact ContactPerson Alternate namesContactpersoon DefinitionContacts 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'. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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relationship | 0..* | CodeableConceptBinding | Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. 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. Unordered, Open, by $this(Value) BindingHL7 v2 Value Set 0131 (extensible) Constraints
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relationship | 0..* | CodeableConceptBinding | Element IdPatient.contact.relationship:relationship Relationship Alternate namesRelatie DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. 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.
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role | 0..* | CodeableConceptBinding | Element IdPatient.contact.relationship:role Role Alternate namesRol DefinitionExpectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon') Used to determine which contact person is the most relevant to approach, depending on circumstances. 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.
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name | 0..1 | nl-core-humanname | Element IdPatient.contact.name NameInformation Alternate namesNaamgegevens DefinitionA human's name with the ability to identify parts and usage. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. 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. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas"
Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "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", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Unstructured HumanName { "use": "official", "text": "Irma Jongeneel-de Haas" } Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameAssemblyOrder | 0..1 | ExtensionBinding | There are no (further) constraints on this element Element IdPatient.contact.name.extension:humannameAssemblyOrder Preferred display order of name parts Alternate namesextensions, user content, Voorkeursvolgorde van de naamdelen. DefinitionA code that represents the preferred display order of the components of this human name. 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. http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Bindingname-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.extension:humannameAssemblyOrder.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-assembly-order
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valueCode | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.name.extension:humannameAssemblyOrder.valueCode:valueCode Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded name-assembly-order (required) Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.name.use usual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name. Allows the appropriate name for a particular context of use to be selected from among a set of names. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.text Text representation of the full name DefinitionA full text representation of the name. A renderable, unencoded form. Can provide both a text representation and structured parts.
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family | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.family Surname Alternate namessurname, Achternaam DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameOwnPrefix | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnPrefix PrefixOwnName Alternate namesextensions, user content, VoorvoegselGeslachtsnaam DefinitionThe 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. 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. http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnPrefix.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannameOwnName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnName OwnName Alternate namesextensions, user content, Geslachtsnaam DefinitionThe person’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannameOwnName.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerPrefix | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerPrefix PrefixSurname Alternate namesextensions, user content, VoorvoegselGeslachtsnaamPartner DefinitionVoorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. 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. http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerPrefix.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerName LastNamePartner Alternate namesextensions, user content, GeslachtsnaamPartner DefinitionPartner’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.name.family.extension:humannamePartnerName.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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given | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.contact.name.given Given Alternate namesfirst name, middle name, Voornamen, Initialen, Roepnaam DefinitionNote that in order to mark the type of a given name, that you use the FHIR standard extension for ISO 21090 EN Qualifiers. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the Zib for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier 'BR' maps to the Zib concept FirstNames, 'IN' maps to Initials and 'CL' to GivenName.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.name.given.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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iso21090EnQualifier | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.contact.name.given.extension:iso21090EnQualifier LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV Alternate namesextensions, user content DefinitionA set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Used to indicate additional information about the name part and how it should be used. http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.name.given.extension:iso21090EnQualifier.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
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valueCode | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.name.given.extension:iso21090EnQualifier.value[x]:valueCode Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded name-part-qualifier (required) Constraints
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.contact.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings may not exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.contact.name.suffix Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings may not exceed 1MB in size
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.name.period Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. 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.
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telecom | 0..* | nl-core-contactpoint | Element IdPatient.contact.telecom ContactInformation Alternate namesContactgegevens DefinitionContact 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.
People have (primary) ways to contact them in some way such as phone, email. 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
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
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address | 0..1 | nl-core-address | Element IdPatient.contact.address AddressInformation Alternate namesAdresInformatie, Adresgegevens DefinitionThis 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.
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. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is for postal addresses, not physical locations.
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
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings may not exceed 1MB in size administrative-gender (required) Constraints
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organization | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. 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.
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period | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. 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.
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animal | Σ ?! | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdPatient.animal This patient is known to be an animal (non-human) DefinitionThis patient is known to be an animal. Many clinical systems are extended to care for animal patients as well as human. 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).
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species | Σ | 1..1 | CodeableConcept | There are no (further) constraints on this element Element IdPatient.animal.species E.g. Dog, Cow DefinitionIdentifies the high level taxonomic categorization of the kind of animal. Need to know what kind of animal. 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.).
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breed | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdPatient.animal.breed E.g. Poodle, Angus DefinitionIdentifies the detailed categorization of the kind of animal. May need to know the specific kind within the species. 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.
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genderStatus | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdPatient.animal.genderStatus E.g. Neutered, Intact DefinitionIndicates the current state of the animal's reproductive organs. Gender status can affect housing and animal behavior. 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.
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communication | 0..* | BackboneElement | Element IdPatient.communication A list of Languages which may be used to communicate with the patient about his or her health Alternate namesTaalvaardigheid DefinitionLanguages which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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extension | 0..* | Extension | Element IdPatient.communication.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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languageProficiency | 0..* | Extension(Complex) | Element IdPatient.communication.extension:languageProficiency Proficiency level of the communication Alternate namesextensions, user content DefinitionProficiency level of the communication. 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:
Extension(Complex) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/patient-proficiency Constraints
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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type | 1..1 | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:type The proficiency type of the communication Alternate namesextensions, user content DefinitionWhat type of communication for the proficiency (spoken, written, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:type.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
type
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valueCoding | 1..1 | CodingBinding | Element IdPatient.communication.extension:languageProficiency.extension:type.valueCoding:valueCoding Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded TaalvaardigheidBegrijpenCodelijst (extensible) Constraints
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level | 1..1 | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:level The proficiency level of the communication Alternate namesextensions, user content DefinitionHow well the patient can communicate this communication (good, poor, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:level.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
level
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valueCoding | 1..1 | CodingBinding | Element IdPatient.communication.extension:languageProficiency.extension:level.valueCoding:valueCoding Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded TaalvaardigheidBegrijpenCodelijst (extensible) Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/patient-proficiency
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value[x] | 0..0 | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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comment | 0..* | Extension(string) | Element IdPatient.communication.extension:comment Comment Alternate namesextensions, user content, Toelichting DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/Comment Constraints
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language | 1..1 | CodeableConceptBinding | Element IdPatient.communication.language CommunicationLanguage Alternate namesCommunicatieTaal DefinitionThe 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. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. 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.
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | 0..1 | Reference(nl-core-organization | nl-core-practitioner) | Element IdPatient.generalPractitioner GeneralPractitioner Alternate namescareProvider, Huisarts DefinitionPatient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/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. Reference(nl-core-organization | nl-core-practitioner) Constraints
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extension | 0..* | Extension | Element IdPatient.generalPractitioner.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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practitionerRole | 0..1 | Extension(Reference(nl-core-practitionerrole)) | Element IdPatient.generalPractitioner.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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managingOrganization | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple usecases:
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'.
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other | Σ | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(Patient | RelatedPerson) Constraints
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso - type of link DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings may not exceed 1MB in size
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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 | HumanName | Element IdHumanName Name of a human - parts and usage DefinitionA human's name with the ability to identify parts and usage. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. 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. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas"
Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "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", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Unstructured HumanName { "use": "official", "text": "Irma Jongeneel-de Haas" } Mappings
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extension | 0..* | Extension | Element IdHumanName.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameAssemblyOrder | 0..1 | ExtensionBinding | Element IdHumanName.extension:humannameAssemblyOrder Preferred display order of name parts Alternate namesextensions, user content, Voorkeursvolgorde van de naamdelen. DefinitionA code that represents the preferred display order of the components of this human name. 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. http://hl7.org/fhir/StructureDefinition/humanname-assembly-order Bindingname-assembly-order (required) Permitted Values NaamgebruikCodelijst-to-HumanNameAssemblyOrder Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdHumanName.use usual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name. Allows the appropriate name for a particular context of use to be selected from among a set of names. 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.
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text | Σ | 0..1 | string | Element IdHumanName.text Text representation of the full name DefinitionA full text representation of the name. A renderable, unencoded form. Can provide both a text representation and structured parts.
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family | Σ | 0..1 | string | Element IdHumanName.family Surname Alternate namessurname, Achternaam DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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extension | 0..* | Extension | Element IdHumanName.family.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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humannameOwnPrefix | 0..1 | Extension | Element IdHumanName.family.extension:humannameOwnPrefix PrefixOwnName Alternate namesextensions, user content, VoorvoegselGeslachtsnaam DefinitionThe 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. 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. http://hl7.org/fhir/StructureDefinition/humanname-own-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdHumanName.family.extension:humannameOwnPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdHumanName.family.extension:humannameOwnPrefix.valueString:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannameOwnName | 0..1 | Extension | Element IdHumanName.family.extension:humannameOwnName OwnName Alternate namesextensions, user content, Geslachtsnaam DefinitionThe person’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-own-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdHumanName.family.extension:humannameOwnName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-own-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdHumanName.family.extension:humannameOwnName.valueString:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerPrefix | 0..1 | Extension | Element IdHumanName.family.extension:humannamePartnerPrefix PrefixSurname Alternate namesextensions, user content, VoorvoegselGeslachtsnaamPartner DefinitionVoorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable. 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. http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdHumanName.family.extension:humannamePartnerPrefix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdHumanName.family.extension:humannamePartnerPrefix.valueString:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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humannamePartnerName | 0..1 | Extension | Element IdHumanName.family.extension:humannamePartnerName LastNamePartner Alternate namesextensions, user content, GeslachtsnaamPartner DefinitionPartner’s official last name. 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". http://hl7.org/fhir/StructureDefinition/humanname-partner-name Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdHumanName.family.extension:humannamePartnerName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/humanname-partner-name
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdHumanName.family.extension:humannamePartnerName.valueString:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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given | Σ | 0..* | string | Element IdHumanName.given Given Alternate namesfirst name, middle name, Voornamen, Initialen, Roepnaam DefinitionNote that in order to mark the type of a given name, that you use the FHIR standard extension for ISO 21090 EN Qualifiers. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the Zib for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier 'BR' maps to the Zib concept FirstNames, 'IN' maps to Initials and 'CL' to GivenName.
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extension | 0..* | Extension | Element IdHumanName.given.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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. 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. Unordered, Open, by url(Value) Constraints
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iso21090EnQualifier | 0..1 | Extension(code) | Element IdHumanName.given.extension:iso21090EnQualifier LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV Alternate namesextensions, user content DefinitionA set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Used to indicate additional information about the name part and how it should be used. http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdHumanName.given.extension:iso21090EnQualifier.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
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valueCode | 0..1 | codeBinding | There are no (further) constraints on this element Element IdHumanName.given.extension:iso21090EnQualifier.valueCode:valueCode Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded name-part-qualifier (required) Constraints
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdHumanName.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings may not exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdHumanName.suffix Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings may not exceed 1MB in size
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdHumanName.period Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. 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.
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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>
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:
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