Page Status: updated 2024-12-18

Patient

Page index

Introduction

The Patient resource, shown in the profile NLLPatient, represents a person who has one or more prescriptions (MedicationRequest) or in some cases only dispenses (MedicationDispenses), either active or in-active (within the legitimate timeframe) in the National Medication List.

A patient is normally fetched from NLL to get the logical identifier, which is used in subsequent interactions. For cases where the patient doesn't have a personal identifier, it is instead created as part of the MedicationRequest, i.e. the information about the person is contained within the medication request.

Regarding information about how the "must support"-property is used in the Swedish National MedicationList, please refer to the page Resources

Overview

Förbättringsförlag med tabbar.

idS Σ0..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedS Σ0..1instant
sourceΣ0..1uri
profileΣ0..*canonical(StructureDefinition)
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uriFixed Value
valueS Σ I1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeS Σ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
id0..1string
nllNameQualifierS I0..*Extension(code)Binding
value0..1System.String
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
telecomΣ I0..*ContactPoint
genderS Σ0..1codeBinding
birthDateS Σ0..1date
deceasedBooleanboolean
id0..1string
nllMunicipalityCodeS I0..1Extension(code)Binding
nllRegionCodeS I0..1Extension(code)Binding
useΣ ?!0..1codeBinding
typeΣ0..1codeBinding
textΣ0..1string
lineΣ0..*string
cityΣ0..1string
districtΣ0..1string
stateΣ0..1string
postalCodeΣ0..1string
countryΣ0..1string
periodΣ I0..1Period
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding
buttons}}
Patient
DefinitionAdministrative information, such as name and identification number, about an individual which may exists as a patient in the Swedish National Medications List
Cardinality0...*
AliasSubjectOfCare Client Resident
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: Patient[classCode=PAT]
  • cda: ClinicalDocument.recordTarget.patientRole
  • EHM: Patient
Patient.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Mappings
  • EHM: Patient-id
Patient.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
Patient.meta.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.meta.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.meta.versionId
DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Cardinality0...1
Typeid
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.meta.lastUpdated
DefinitionWhen the resource last changed - e.g. when the version changed.
Cardinality0...1
Typeinstant
Must SupportTrue
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.meta.source
DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Cardinality0...1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.meta.profile
DefinitionA list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
Cardinality0...*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.meta.security
DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality0...*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

security-labels (extensible)
Must SupportTrue
SummaryTrue
Comments

Security labels are used for two purposes in this resourse. The SUBSETTED label indicates that the resource is an incomplete representation of the information in the Swedish Population Registry. The PROTECTIDENT label indicates that the person's record is marked with an protected identity label of some kind in the Swedish Population Registry. The DEMO label work in tandem with the PROTECTIDENT flag.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
Patient.meta.security.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.meta.security.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.meta.security.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Patient.meta.security.version
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.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Patient.meta.security.code
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).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Patient.meta.security.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Patient.meta.security.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Patient.meta.tag
DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality0...*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)
SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
Patient.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Patient.text
DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
Patient.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
Patient.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.extension:nllPopulationRegistered
DefinitionDescribes whether the patient is registered in the Swedish Population Register (sv folkbokförd) or not. Calculated by the Swedish eHealth Agency.
Cardinality0...1
TypeExtension(Coding)
BindingFolkbokförd (population-registered-status) (extensible)
Must SupportTrue
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Folkbokförd
Patient.extension:nllPopulationRegistered.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.extension:nllPopulationRegistered.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.extension:nllPopulationRegistered.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

http://electronichealth.se/fhir/StructureDefinition/NLLPopulationRegistered

Mappings
  • rim: N/A
Patient.extension:nllPopulationRegistered.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...1
TypeCoding
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
Patient.extension:nllPopulationRegistered.value[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.extension:nllPopulationRegistered.value[x].extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.extension:nllPopulationRegistered.value[x].system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Patient.extension:nllPopulationRegistered.value[x].version
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.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Patient.extension:nllPopulationRegistered.value[x].code
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).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Patient.extension:nllPopulationRegistered.value[x].display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Patient.extension:nllPopulationRegistered.value[x].userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Patient.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.identifier
DefinitionA national identification number. The only supported type of identification is currently Swedish personal identity number.
Cardinality0...*
TypeIdentifier
Must SupportTrue
SummaryTrue
Requirements

Patients are almost always assigned specific numerical identifiers.

SlicingUnordered, Open, by system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
Patient.identifier:pnr
DefinitionSwedish personal identity number (sv: personnummer)
Cardinality0...1
TypeIdentifier
Must SupportTrue
SummaryTrue
Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
  • EHM: Personnummer
Patient.identifier:pnr.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.identifier:pnr.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.identifier:pnr.use
DefinitionThe purpose of this identifier.
Cardinality0...1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
Patient.identifier:pnr.type
DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality0...1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Patient.identifier:pnr.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

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

http://electronichealth.se/identifier/personnummer

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Patient.identifier:pnr.value
DefinitionSwedish personal identity number expressed as 12 digits without hyphen.
Cardinality1...1
Typestring
Must SupportTrue
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • swe-id-rule: A personal identity number must have 12 digits
    $this.matches('^\\d{12}$')
Examples
General

123456


Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Patient.identifier:pnr.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...1
TypePeriod
SummaryTrue
Comments

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").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Patient.identifier:pnr.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
Patient.active
DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Cardinality0...1
Typeboolean
Must SupportTrue
ModifierTrue
SummaryTrue
Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.status
  • rim: statusCode
  • cda: n/a
  • EHM: Aktiv
Patient.name
DefinitionA name associated with the individual.
Cardinality0...1
TypeHumanName
Must SupportTrue
SummaryTrue
Requirements

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

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN
  • rim: EN (actually, PN)
  • servd: ProviderName
  • v2: PID-5, PID-9
  • rim: name
  • cda: .patient.name
Patient.name.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.name.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.name.use
DefinitionIdentifies the purpose for this name.
Cardinality0...1
Typecode
Binding

The use of a human name.

NameUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN.7, but often indicated by which field contains the name
  • rim: unique(./use)
  • servd: ./NamePurpose
Patient.name.text
DefinitionSpecifies the entire name as it should be displayed. This may be provided instead of or as well as the specific parts. Maximum length 36 characters if the patient is from FOLK and 60 characters if the patient is not from FOLK.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: implied by XPN.11
  • rim: ./formatted
  • EHM: Redigerat namn
  • EHM: Fullständigt namn
Patient.name.family
DefinitionIn the scenario that the name has been fetched from the Population Register (sv: folkbokföring) the maximum string length for the family name is 100. In the scenario that the patient's name is provided by an external system (when a patient does not have a personal identity number) the maxmimun string length for family name is 35.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Aliassurname
Comments

Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. This is mapped as middle name + space + family name (eg "Johansson Svensson") when this resource represents a person in the populatoin registry.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN.1/FN.1
  • rim: ./part[partType = FAM]
  • servd: ./FamilyName
  • EHM: Efternamn
Patient.name.given
DefinitionIn the scenario that the name has been fetched from the Population Register (sv: folkbokföring) there can be multiple given names. Total maxmimun string length for all given names are 80. In the scenario that the patient's name is provided by an external system (when a patient does not have a personal identity number) only one (1) given name is allowed. Maxmimun string length for that given name is 35.
Cardinality0...*
Typestring
Must SupportTrue
SummaryTrue
Aliasfirst name, middle name
Comments

Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. The "call me" name in a list of multiple given names (first name + middle names in FHIR) is marked with CL by the extension nllNameQualifier.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN.2 + XPN.3
  • rim: ./part[partType = GIV]
  • servd: ./GivenNames
  • EHM: Förnamn
Patient.name.given.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.name.given.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.name.given.extension:nllNameQualifier
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 describe "tilltalsnamn".
Cardinality0...*
TypeExtension(code)
BindingTilltalsnamnsmarkering (name-part-qualifier) (required)
Must SupportTrue
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • rim: ENXP.qualifier
  • EHM: Tilltalsnamnsmarkering
Patient.name.given.value
DefinitionPrimitive value for string
Cardinality0...1
TypeSystem.String
Patient.name.prefix
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.
Cardinality0...*
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN.5
  • rim: ./part[partType = PFX]
  • servd: ./TitleCode
Patient.name.suffix
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.
Cardinality0...*
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN/4
  • rim: ./part[partType = SFX]
Patient.name.period
DefinitionIndicates the period of time when this name was valid for the named person.
Cardinality0...1
TypePeriod
SummaryTrue
Requirements

Allows names to be placed in historical context.

Comments

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").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: XPN.13 + XPN.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
Patient.telecom
DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Cardinality0...*
TypeContactPoint
SummaryTrue
Requirements

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

Comments

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cpt-2: A system is required if a value is provided.
    value.empty() or system.exists()
Mappings
  • rim: n/a
  • v2: XTN
  • rim: TEL
  • servd: ContactPoint
  • v2: PID-13, PID-14, PID-40
  • rim: telecom
  • cda: .telecom
Patient.gender
DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Used only when personal identity number is missing.
Cardinality0...1
Typecode
Binding

The gender of a person used for administrative purposes.

Kön (administrative-gender) (required)
Must SupportTrue
SummaryTrue
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: PID-8
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: .patient.administrativeGenderCode
  • EHM: Kön
Patient.birthDate
DefinitionThe date of birth for the individual. Used only when personal identity number is missing.
Cardinality0...1
Typedate
Must SupportTrue
SummaryTrue
Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: PID-7
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
  • cda: .patient.birthTime
  • loinc: 21112-8
  • EHM: Födelsedatum
Patient.deceased[x]
DefinitionIndicates if the individual is deceased or not. This flag is in the Swedish National Mediations List a translation from status 4 (sv: Person avliden) in FOLK.
Cardinality0...1
Typeboolean
Must SupportTrue
ModifierTrue
SummaryTrue
Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance it means there is no statement on whether or not the individual is deceased, should be interpreted that patient is NOT deceased.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: PID-30 (bool) and PID-29 (datetime)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
  • cda: n/a
  • EHM: Avliden
Patient.address
DefinitionThe Swedish National Medications List only returns a municipality code (sv kommunkod) and a region code (sv läns-/regionkod)
Cardinality0...1
TypeAddress
Must SupportTrue
SummaryTrue
Requirements

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

Comments

Patient may have multiple addresses with different uses or applicable periods.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD
  • rim: AD
  • servd: Address
  • v2: PID-11
  • rim: addr
  • cda: .addr
  • EHM: Personadress
Patient.address.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.address.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.address.extension:nllMunicipalityCode
DefinitionMunicipality code, also called Official Municipality Key (sv: kommunkod) are four letter numeric codes which identfies a municipality (sv: kommun) in Sweden. Codes are decided by SCB. Example: Kalmar 0880
Cardinality0...1
TypeExtension(code)
Binding

Statistics in Sweden (SCB)

http://scb.se (required)
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Kommun
Patient.address.extension:nllRegionCode
DefinitionRegion code is a two letter numeric code for regions (sv: region/län) in Sweden
Cardinality0...1
TypeExtension(code)
Binding

Statistics in Sweden (SCB)

http://scb.se (required)
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Län
Patient.address.use
DefinitionThe purpose of this address.
Cardinality0...1
Typecode
Binding

The use of an address.

AddressUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

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

home


Mappings
  • rim: n/a
  • v2: XAD.7
  • rim: unique(./use)
  • servd: ./AddressPurpose
Patient.address.type
DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
Cardinality0...1
Typecode
Binding

The type of an address (physical / postal).

AddressType (required)
SummaryTrue
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

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

both


Mappings
  • rim: n/a
  • v2: XAD.18
  • rim: unique(./use)
  • vcard: address type parameter
Patient.address.text
DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
Cardinality0...1
Typestring
SummaryTrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

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

137 Nowhere Street, Erewhon 9132


Mappings
  • rim: n/a
  • v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
  • rim: ./formatted
  • vcard: address label parameter
Patient.address.line
DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Cardinality0...*
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

137 Nowhere Street


Mappings
  • rim: n/a
  • v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
  • rim: AD.part[parttype = AL]
  • vcard: street
  • servd: ./StreetAddress (newline delimitted)
Patient.address.city
DefinitionThe name of the city, town, suburb, village or other community or delivery center.
Cardinality0...1
Typestring
SummaryTrue
AliasMunicpality
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

Erewhon


Mappings
  • rim: n/a
  • v2: XAD.3
  • rim: AD.part[parttype = CTY]
  • vcard: locality
  • servd: ./Jurisdiction
Patient.address.district
DefinitionThe name of the administrative area (county).
Cardinality0...1
Typestring
SummaryTrue
AliasCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

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

Madison


Mappings
  • rim: n/a
  • v2: XAD.9
  • rim: AD.part[parttype = CNT | CPA]
Patient.address.state
DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
Cardinality0...1
Typestring
SummaryTrue
AliasProvince, Territory
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD.4
  • rim: AD.part[parttype = STA]
  • vcard: region
  • servd: ./Region
Patient.address.postalCode
DefinitionA postal code designating a region defined by the postal service.
Cardinality0...1
Typestring
SummaryTrue
AliasZip
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

9132


Mappings
  • rim: n/a
  • v2: XAD.5
  • rim: AD.part[parttype = ZIP]
  • vcard: code
  • servd: ./PostalIdentificationCode
Patient.address.country
DefinitionCountry - a nation as commonly understood or generally accepted.
Cardinality0...1
Typestring
SummaryTrue
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD.6
  • rim: AD.part[parttype = CNT]
  • vcard: country
  • servd: ./Country
Patient.address.period
DefinitionTime period when address was/is in use.
Cardinality0...1
TypePeriod
SummaryTrue
Requirements

Allows addresses to be placed in historical context.

Comments

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").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Examples
General

{
  "start": "2010-03-23",
  "end": "2010-07-01"
}


Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: XAD.12 / XAD.13 + XAD.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
Patient.maritalStatus
DefinitionThis field contains a patient's most recent marital (civil) status.
Cardinality0...1
TypeCodeableConcept
Binding

The domestic partnership status of a person.

Marital Status Codes (extensible)
Requirements

Most, if not all systems capture it.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PID-16
  • rim: player[classCode=PSN]/maritalStatusCode
  • cda: .patient.maritalStatusCode
Patient.multipleBirth[x]
DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Cardinality0...1
Typeboolean
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: PID-24 (bool), PID-25 (integer)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
  • cda: n/a
Patient.photo
DefinitionImage of the patient.
Cardinality0...*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • att-1: If the Attachment has data, it SHALL have a contentType
    data.empty() or contentType.exists()
Mappings
  • rim: n/a
  • v2: ED/RP
  • rim: ED
  • v2: OBX-5 - needs a profile
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
  • cda: n/a
Patient.contact
DefinitionA contact party (e.g. guardian, partner, friend) for the patient.
Cardinality0...*
TypeBackboneElement
Requirements

Need to track people you can contact about the patient.

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • pat-1: SHALL at least contain a contact's details or a reference to an organization
    name.exists() or telecom.exists() or address.exists() or organization.exists()
Mappings
  • rim: n/a
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
  • cda: n/a
Patient.contact.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.contact.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.contact.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.contact.relationship
DefinitionThe nature of the relationship between the patient and the contact person.
Cardinality0...*
TypeCodeableConcept
Binding

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

PatientContactRelationship (extensible)
Requirements

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

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: NK1-7, NK1-3
  • rim: code
  • cda: n/a
Patient.contact.name
DefinitionA name associated with the contact person.
Cardinality0...1
TypeHumanName
Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Comments

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 might or might 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XPN
  • rim: EN (actually, PN)
  • servd: ProviderName
  • v2: NK1-2
  • rim: name
  • cda: n/a
Patient.contact.telecom
DefinitionA contact detail for the person, e.g. a telephone number or an email address.
Cardinality0...*
TypeContactPoint
Requirements

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

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cpt-2: A system is required if a value is provided.
    value.empty() or system.exists()
Mappings
  • rim: n/a
  • v2: XTN
  • rim: TEL
  • servd: ContactPoint
  • v2: NK1-5, NK1-6, NK1-40
  • rim: telecom
  • cda: n/a
Patient.contact.address
DefinitionAddress for the contact person.
Cardinality0...1
TypeAddress
Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Comments

Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XAD
  • rim: AD
  • servd: Address
  • v2: NK1-4
  • rim: addr
  • cda: n/a
Patient.contact.gender
DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Cardinality0...1
Typecode
Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)
Requirements

Needed to address the person correctly.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NK1-15
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: n/a
Patient.contact.organization
DefinitionOrganization on behalf of which the contact is acting or for which the contact is working.
Cardinality0...1
TypeReference(Organization)
Requirements

For guardians or business related contacts, the organization is relevant.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
  • rim: scoper
  • cda: n/a
Patient.contact.period
DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient.
Cardinality0...1
TypePeriod
Comments

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").

Period is not used for a duration (a measure of elapsed time). See Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • rim: effectiveTime
  • cda: n/a
Patient.communication
DefinitionA language which may be used to communicate with the patient about his or her health.
Cardinality0...*
TypeBackboneElement
Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: LanguageCommunication
  • cda: patient.languageCommunication
Patient.communication.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.communication.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.communication.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.communication.language
DefinitionThe 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.
Cardinality1...1
TypeCodeableConcept
Binding

A human language.

CommonLanguages (preferred)
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PID-15, LAN-2
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
  • cda: .languageCode
Patient.communication.preferred
DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Cardinality0...1
Typeboolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Comments

This language is specifically identified for communicating healthcare information.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: PID-15
  • rim: preferenceInd
  • cda: .preferenceInd
Patient.generalPractitioner
DefinitionPatient's nominated care provider.
Cardinality0...*
TypeReference(Organization | Practitioner | PractitionerRole)
AliascareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PD1-4
  • rim: subjectOf.CareEvent.performer.AssignedEntity
  • cda: n/a
Patient.managingOrganization
DefinitionOrganization that is the custodian of the patient record.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: scoper
  • cda: .providerOrganization
Patient.link
DefinitionLink to another patient resource that concerns the same actual patient.
Cardinality0...*
TypeBackboneElement
ModifierTrue
SummaryTrue
Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

There is no assumption that linked patient records have mutual links.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: outboundLink
  • cda: n/a
Patient.link.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Patient.link.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.link.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Patient.link.other
DefinitionThe other patient resource that the link refers to.
Cardinality1...1
TypeReference(Patient | RelatedPerson)
SummaryTrue
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PID-3, MRG-1
  • rim: id
  • cda: n/a
Patient.link.type
DefinitionThe type of link between this patient resource and another patient resource.
Cardinality1...1
Typecode
Binding

The type of link between this patient resource and another patient resource.

LinkType (required)
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: typeCode
  • cda: n/a
<StructureDefinition xmlns="http://hl7.org/fhir">
    <url value="http://electronichealth.se/fhir/StructureDefinition/NLLPatient" />
    <version value="1.0.2" />
    <name value="NLLPatient" />
    <status value="active" />
    <date value="2023-06-12" />
    <publisher value="Swedish eHealth Agency" />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="EHM" />
        <name value="E-h&#228;lsomyndigheten concept" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Patient" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
    <derivation value="constraint" />
    <differential>
        <element id="Patient">
            <path value="Patient" />
            <short value="Information about an individual as a patient in the Swedish National Medications List" />
            <definition value="Administrative information, such as name and identification number, about an individual which may exists as a patient in the Swedish National Medications List" />
            <mapping>
                <identity value="EHM" />
                <map value="Patient" />
            </mapping>
        </element>
        <element id="Patient.id">
            <path value="Patient.id" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Patient-id" />
            </mapping>
        </element>
        <element id="Patient.meta">
            <path value="Patient.meta" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.meta.lastUpdated">
            <path value="Patient.meta.lastUpdated" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.meta.security">
            <path value="Patient.meta.security" />
            <comment value="Security labels are used for two purposes in this resourse.\nThe SUBSETTED label indicates that the resource is an incomplete representation of the information in the Swedish Population Registry.\nThe PROTECTIDENT label indicates that the person&#39;s record is marked with an protected identity label of some kind in the Swedish Population Registry.\nThe DEMO label work in tandem with the PROTECTIDENT flag." />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/security-labels" />
            </binding>
        </element>
        <element id="Patient.meta.security.system">
            <path value="Patient.meta.security.system" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.meta.security.version">
            <path value="Patient.meta.security.version" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.meta.security.code">
            <path value="Patient.meta.security.code" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.extension:nllPopulationRegistered">
            <path value="Patient.extension" />
            <sliceName value="nllPopulationRegistered" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLPopulationRegistered" />
            </type>
            <meaningWhenMissing value="A missing value shall be interpreted as UNKNOWN" />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/population-registered-status" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Folkbokf&#246;rd" />
            </mapping>
        </element>
        <element id="Patient.extension:nllPopulationRegistered.value[x]">
            <path value="Patient.extension.value[x]" />
        </element>
        <element id="Patient.extension:nllPopulationRegistered.value[x].system">
            <path value="Patient.extension.value[x].system" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.extension:nllPopulationRegistered.value[x].version">
            <path value="Patient.extension.value[x].version" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.extension:nllPopulationRegistered.value[x].code">
            <path value="Patient.extension.value[x].code" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <definition value="A national identification number. The only supported type of identification is currently Swedish personal identity number." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:pnr">
            <path value="Patient.identifier" />
            <sliceName value="pnr" />
            <short value="Swedish personal identity number" />
            <definition value="Swedish personal identity number (sv: personnummer)" />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Personnummer" />
            </mapping>
        </element>
        <element id="Patient.identifier:pnr.system">
            <path value="Patient.identifier.system" />
            <min value="1" />
            <fixedUri value="http://electronichealth.se/identifier/personnummer" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:pnr.value">
            <path value="Patient.identifier.value" />
            <short value="Swedish personal identity number" />
            <definition value="Swedish personal identity number expressed as 12 digits without hyphen." />
            <min value="1" />
            <maxLength value="12" />
            <constraint>
                <key value="swe-id-rule" />
                <severity value="error" />
                <human value="A personal identity number must have 12 digits" />
                <expression value="$this.matches(&#39;^\\d{12}$&#39;)" />
                <source value="Patient" />
            </constraint>
            <mustSupport value="true" />
        </element>
        <element id="Patient.active">
            <path value="Patient.active" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Aktiv" />
            </mapping>
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.name.text">
            <path value="Patient.name.text" />
            <definition value="Specifies the entire name as it should be displayed. This may be provided instead of or as well as the specific parts. Maximum length 36 characters if the patient is from FOLK and 60 characters if the patient is not from FOLK." />
            <maxLength value="60" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Redigerat namn" />
                <comment value="Patient finns i FOLK" />
            </mapping>
            <mapping>
                <identity value="EHM" />
                <map value="Fullst&#228;ndigt namn" />
                <comment value="Patient saknas i FOLK" />
            </mapping>
        </element>
        <element id="Patient.name.family">
            <path value="Patient.name.family" />
            <definition value="In the scenario that the name has been fetched from the Population Register (sv: folkbokf&#246;ring)  the maximum string length for the family name is 100.\nIn the scenario that the patient&#39;s name is provided by an external system (when a patient does not have a personal identity number) the maxmimun string length for family name is 35." />
            <comment value="Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. This is mapped as middle name + space + family name (eg &quot;Johansson Svensson&quot;) when this resource represents a person in the populatoin registry." />
            <maxLength value="100" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Efternamn" />
            </mapping>
        </element>
        <element id="Patient.name.given">
            <path value="Patient.name.given" />
            <short value="Given names" />
            <definition value="In the scenario that the name has been fetched from the Population Register (sv: folkbokf&#246;ring) there can be multiple given names. Total maxmimun string length for all given names are 80.\nIn the scenario that the patient&#39;s name is provided by an external system (when a patient does not have a personal identity number) only one (1) given name is allowed. Maxmimun string length for that given name is 35." />
            <comment value="Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. The &quot;call me&quot; name in a list of multiple given names (first name + middle names in FHIR) is marked with CL by the extension nllNameQualifier." />
            <maxLength value="80" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="F&#246;rnamn" />
            </mapping>
        </element>
        <element id="Patient.name.given.extension:nllNameQualifier">
            <path value="Patient.name.given.extension" />
            <sliceName value="nllNameQualifier" />
            <short value="CL (call me)" />
            <definition value="A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Used to describe &quot;tilltalsnamn&quot;." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/name-part-qualifier" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Tilltalsnamnsmarkering" />
            </mapping>
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <short value="male | female | unknown" />
            <definition value="Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Used only when personal identity number is missing." />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/administrative-gender" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="K&#246;n" />
                <comment value="Only used when the patient doesn&#39;t have a personal identity number" />
            </mapping>
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <definition value="The date of birth for the individual. Used only when personal identity number is missing." />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="F&#246;delsedatum" />
                <comment value="Only used in cases where the patient doesn&#39;t have/use the national identification number." />
            </mapping>
        </element>
        <element id="Patient.deceased[x]">
            <path value="Patient.deceased[x]" />
            <definition value="Indicates if the individual is deceased or not. This flag is in the Swedish National Mediations List a translation from status 4 (sv: Person avliden) in FOLK." />
            <comment value="If there&#39;s no value in the instance it means there is no statement on whether or not the individual is deceased, should be interpreted that patient is NOT deceased." />
            <type>
                <code value="boolean" />
            </type>
            <meaningWhenMissing value="Person is not deceased" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Avliden" />
            </mapping>
        </element>
        <element id="Patient.address">
            <path value="Patient.address" />
            <definition value="The Swedish National Medications List only returns a municipality code (sv kommunkod) and a region code (sv l&#228;ns-/regionkod)" />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Personadress" />
            </mapping>
        </element>
        <element id="Patient.address.extension:nllMunicipalityCode">
            <path value="Patient.address.extension" />
            <sliceName value="nllMunicipalityCode" />
            <short value="Municipality code (sv. kommunkod)" />
            <definition value="Municipality code, also called Official Municipality Key (sv: kommunkod) are four letter numeric codes which identfies a municipality (sv: kommun) in Sweden. Codes are decided by SCB.\nExample: Kalmar 0880" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLMunicipalityCode" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <description value="Statistics in Sweden (SCB)" />
                <valueSet value="http://scb.se" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Kommun" />
            </mapping>
        </element>
        <element id="Patient.address.extension:nllRegionCode">
            <path value="Patient.address.extension" />
            <sliceName value="nllRegionCode" />
            <short value="Region code (sv: region/l&#228;nskod)" />
            <definition value="Region code is a two letter numeric code for regions (sv: region/l&#228;n) in Sweden" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLRegionCode" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <description value="Statistics in Sweden (SCB)" />
                <valueSet value="http://scb.se" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="L&#228;n" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "url": "http://electronichealth.se/fhir/StructureDefinition/NLLPatient",
    "version": "1.0.2",
    "name": "NLLPatient",
    "status": "active",
    "date": "2023-06-12",
    "publisher": "Swedish eHealth Agency",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "EHM",
            "name": "E-hälsomyndigheten concept"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient",
                "path": "Patient",
                "short": "Information about an individual as a patient in the Swedish National Medications List",
                "definition": "Administrative information, such as name and identification number, about an individual which may exists as a patient in the Swedish National Medications List",
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Patient"
                    }
                ]
            },
            {
                "id": "Patient.id",
                "path": "Patient.id",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Patient-id"
                    }
                ]
            },
            {
                "id": "Patient.meta",
                "path": "Patient.meta",
                "mustSupport": true
            },
            {
                "id": "Patient.meta.lastUpdated",
                "path": "Patient.meta.lastUpdated",
                "mustSupport": true
            },
            {
                "id": "Patient.meta.security",
                "path": "Patient.meta.security",
                "comment": "Security labels are used for two purposes in this resourse.\nThe SUBSETTED label indicates that the resource is an incomplete representation of the information in the Swedish Population Registry.\nThe PROTECTIDENT label indicates that the person's record is marked with an protected identity label of some kind in the Swedish Population Registry.\nThe DEMO label work in tandem with the PROTECTIDENT flag.",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/security-labels"
                }
            },
            {
                "id": "Patient.meta.security.system",
                "path": "Patient.meta.security.system",
                "mustSupport": true
            },
            {
                "id": "Patient.meta.security.version",
                "path": "Patient.meta.security.version",
                "mustSupport": true
            },
            {
                "id": "Patient.meta.security.code",
                "path": "Patient.meta.security.code",
                "mustSupport": true
            },
            {
                "id": "Patient.extension:nllPopulationRegistered",
                "path": "Patient.extension",
                "sliceName": "nllPopulationRegistered",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLPopulationRegistered"
                        ]
                    }
                ],
                "meaningWhenMissing": "A missing value shall be interpreted as UNKNOWN",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/population-registered-status"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Folkbokförd"
                    }
                ]
            },
            {
                "id": "Patient.extension:nllPopulationRegistered.value[x]",
                "path": "Patient.extension.value[x]"
            },
            {
                "id": "Patient.extension:nllPopulationRegistered.value[x].system",
                "path": "Patient.extension.value[x].system",
                "mustSupport": true
            },
            {
                "id": "Patient.extension:nllPopulationRegistered.value[x].version",
                "path": "Patient.extension.value[x].version",
                "mustSupport": true
            },
            {
                "id": "Patient.extension:nllPopulationRegistered.value[x].code",
                "path": "Patient.extension.value[x].code",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "rules": "open"
                },
                "definition": "A national identification number. The only supported type of identification is currently Swedish personal identity number.",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:pnr",
                "path": "Patient.identifier",
                "sliceName": "pnr",
                "short": "Swedish personal identity number",
                "definition": "Swedish personal identity number (sv: personnummer)",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Personnummer"
                    }
                ]
            },
            {
                "id": "Patient.identifier:pnr.system",
                "path": "Patient.identifier.system",
                "min": 1,
                "fixedUri": "http://electronichealth.se/identifier/personnummer",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:pnr.value",
                "path": "Patient.identifier.value",
                "short": "Swedish personal identity number",
                "definition": "Swedish personal identity number expressed as 12 digits without hyphen.",
                "min": 1,
                "maxLength": 12,
                "constraint":  [
                    {
                        "key": "swe-id-rule",
                        "severity": "error",
                        "human": "A personal identity number must have 12 digits",
                        "expression": "$this.matches('^\\\\d{12}$')",
                        "source": "Patient"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.active",
                "path": "Patient.active",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Aktiv"
                    }
                ]
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Patient.name.text",
                "path": "Patient.name.text",
                "definition": "Specifies the entire name as it should be displayed. This may be provided instead of or as well as the specific parts. Maximum length 36 characters if the patient is from FOLK and 60 characters if the patient is not from FOLK.",
                "maxLength": 60,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Redigerat namn",
                        "comment": "Patient finns i FOLK"
                    },
                    {
                        "identity": "EHM",
                        "map": "Fullständigt namn",
                        "comment": "Patient saknas i FOLK"
                    }
                ]
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "definition": "In the scenario that the name has been fetched from the Population Register (sv: folkbokföring)  the maximum string length for the family name is 100.\nIn the scenario that the patient's name is provided by an external system (when a patient does not have a personal identity number) the maxmimun string length for family name is 35.",
                "comment": "Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. This is mapped as middle name + space + family name (eg \"Johansson Svensson\") when this resource represents a person in the populatoin registry.",
                "maxLength": 100,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Efternamn"
                    }
                ]
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "short": "Given names",
                "definition": "In the scenario that the name has been fetched from the Population Register (sv: folkbokföring) there can be multiple given names. Total maxmimun string length for all given names are 80.\nIn the scenario that the patient's name is provided by an external system (when a patient does not have a personal identity number) only one (1) given name is allowed. Maxmimun string length for that given name is 35.",
                "comment": "Middle name has different definitions in the Swedish Population Registry and FHIR. The middle name in the population registry is seen from an FHIR context as an additional family name. The \"call me\" name in a list of multiple given names (first name + middle names in FHIR) is marked with CL by the extension nllNameQualifier.",
                "maxLength": 80,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Förnamn"
                    }
                ]
            },
            {
                "id": "Patient.name.given.extension:nllNameQualifier",
                "path": "Patient.name.given.extension",
                "sliceName": "nllNameQualifier",
                "short": "CL (call me)",
                "definition": "A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. Used to describe \"tilltalsnamn\".",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/name-part-qualifier"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Tilltalsnamnsmarkering"
                    }
                ]
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "short": "male | female | unknown",
                "definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Used only when personal identity number is missing.",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/administrative-gender"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Kön",
                        "comment": "Only used when the patient doesn't have a personal identity number"
                    }
                ]
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "definition": "The date of birth for the individual. Used only when personal identity number is missing.",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Födelsedatum",
                        "comment": "Only used in cases where the patient doesn't have/use the national identification number."
                    }
                ]
            },
            {
                "id": "Patient.deceased[x]",
                "path": "Patient.deceased[x]",
                "definition": "Indicates if the individual is deceased or not. This flag is in the Swedish National Mediations List a translation from status 4 (sv: Person avliden) in FOLK.",
                "comment": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased, should be interpreted that patient is NOT deceased.",
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "meaningWhenMissing": "Person is not deceased",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Avliden"
                    }
                ]
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "definition": "The Swedish National Medications List only returns a municipality code (sv kommunkod) and a region code (sv läns-/regionkod)",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Personadress"
                    }
                ]
            },
            {
                "id": "Patient.address.extension:nllMunicipalityCode",
                "path": "Patient.address.extension",
                "sliceName": "nllMunicipalityCode",
                "short": "Municipality code (sv. kommunkod)",
                "definition": "Municipality code, also called Official Municipality Key (sv: kommunkod) are four letter numeric codes which identfies a municipality (sv: kommun) in Sweden. Codes are decided by SCB.\nExample: Kalmar 0880",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLMunicipalityCode"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "Statistics in Sweden (SCB)",
                    "valueSet": "http://scb.se"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Kommun"
                    }
                ]
            },
            {
                "id": "Patient.address.extension:nllRegionCode",
                "path": "Patient.address.extension",
                "sliceName": "nllRegionCode",
                "short": "Region code (sv: region/länskod)",
                "definition": "Region code is a two letter numeric code for regions (sv: region/län) in Sweden",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLRegionCode"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "Statistics in Sweden (SCB)",
                    "valueSet": "http://scb.se"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Län"
                    }
                ]
            }
        ]
    }
}
Patient..
Patient.id..
Patient.meta..
Patient.meta.lastUpdated..
Patient.meta.security..
Patient.meta.security.system..
Patient.meta.security.version..
Patient.meta.security.code..
Patient.extensionExtension..1
Patient.extension.value[x]..
Patient.extension.value[x].system..
Patient.extension.value[x].version..
Patient.extension.value[x].code..
Patient.identifier..
Patient.identifier..1
Patient.identifier.system1..
Patient.identifier.value1..
Patient.active..
Patient.name..1
Patient.name.text..
Patient.name.family..
Patient.name.given..
Patient.name.given.extensionExtension..
Patient.gender..
Patient.birthDate..
Patient.deceased[x]boolean..
Patient.address..1
Patient.address.extensionExtension..
Patient.address.extensionExtension..



Nuläge utan tabbar

idS Σ0..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedS Σ0..1instant
sourceΣ0..1uri
profileΣ0..*canonical(StructureDefinition)
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uriFixed Value
valueS Σ I1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeS Σ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
id0..1string
nllNameQualifierS I0..*Extension(code)Binding
value0..1System.String
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
telecomΣ I0..*ContactPoint
genderS Σ0..1codeBinding
birthDateS Σ0..1date
deceasedBooleanboolean
id0..1string
nllMunicipalityCodeS I0..1Extension(code)Binding
nllRegionCodeS I0..1Extension(code)Binding
useΣ ?!0..1codeBinding
typeΣ0..1codeBinding
textΣ0..1string
lineΣ0..*string
cityΣ0..1string
districtΣ0..1string
stateΣ0..1string
postalCodeΣ0..1string
countryΣ0..1string
periodΣ I0..1Period
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding

Contained resources

The patient resource will be a contained resource when an explicit business identifier (personal identity number, sv. personnummer) is missing. In that case the patient is identified by name and birthdate.

Cases when patient is a contained resource Resources using patient
No business identifier, ie no personal identity number MedicationRequest,
MedicationDispense

For more information about references and contained resources see Resources - References.

Details

Description of all elements can be found here, Element descriptions.

Mapping of FHIR element names to the National Medication List names can be found here, Element language mappings.

Supported operations

HTTP methods

Operation Supported Comment
Search (GET, POST) yes See below for supported search options.
Insert (POST) no
Update (PUT) no
Delete (DEL) no
Operation (GET, POST) yes See below for supported extended operations.

When interacting with this resource a set of HTTP-headers must be included in the request, see HTTP Header and Authorization.

Query operations

Supported Queries

  1. ../Patient/[id]
  2. ../Patient?identifier=[value]

Compartment searches

Supported searches on a compartment. This kind of search returns a bundle with the related resources.

  1. ../Patient/[id]/MedicationRequest{?[parameters]} returns all related MedicationRequests for the specified patient matching the optional parameters. See MedicationRequest for more details.

    Parameter Description Comment
    authordedon Authored date interval of a prescription
    ..?authoredon=le2021-01-20&authoredon=ge2021-02-01
    Supported prefix: le and ge
    nllPrescriptionChain ID of a prescription chain (UUID)
    ..?nllPrescriptionChain=<uuid>
    status Comma separated list of prescription status
    ..&status=active,on-hold
    See possible values in the status section: MedicationRequest
  2. ../Patient/[id]/Consent returns all related Consents for the specified patient.

  3. ../Patient/[id]/MedicationListInfo returns all related MedicationListInfo's for the specified patient.

Search parameters

Parameter Description Comment
Patient/[id] A read based on the logical ID (UUID) of a patient request
../Patient/<uuid>
identifier Business identifier of a patient including the naming system
..?identifier=http://electronichealth.se/identifier/personnummer%7C196411193086
An identifier is a combination of a type and a value seperated by a | (%7C)

Other operations

Operation name HTTP verbs Comment
$print-prescriptions GET, POST

Invocations

URL: [base]/Patient/[id]/$print-prescriptions

This operation does NOT change content

Parameters (In)

NameCardinalityTypeBindingDocumentation
sortOrder0..1codeSorteringsordning (prescription-sort-orders) (required)

The prescriptions are sorted on AuthoredOn (sv. utfardandedatum) by default. An alternate option is to sort the prescriptions by product name.

Return Values (Out)

NameCardinalityTypeDocumentation
return1..1Binary

A Base64 encoded PDF file with a patient's active prescriptions (status 'active').

Can be invoked with a HTTP POST or GET. This operation is invoked on a Patient resource to initiate the creation of a pdf report which the patients prescriptions with status 'active' and format electronic. NB! The response containes a Binary resource without the parameter format.

$print-dispenses GET, POST

Invocations

URL: [base]/Patient/[id]/$print-dispenses

This operation does NOT change content

Parameters (In)

NameCardinalityTypeDocumentation
whenhandedover0..1Period

The period for when the dispense was handed over. It is possible to enter either period.start, period.end or both.

Return Values (Out)

NameCardinalityTypeDocumentation
return1..1Binary

The Binary resource containes a Base64 encoded PDF file which includes a patient's dispensed medications.

Can be invoked with a HTTP POST or GET. This operation is invoked on a Patient resource to initiate the creation of a PDF report including the patient's dispensed medications. Dispenses of other types of products are not included. NB! The response containes a Binary resource without the parameter format.

$print-dose-prescriptions GET, POST

Invocations

URL: [base]/Patient/[id]/$print-dose-prescriptions

This operation does NOT change content

Parameters (In)

NameCardinalityTypeDocumentation
pharmacyGLN0..1string

If this operation is invoced by a pharmacy, the pharmacy GLN must be provided. Otherwise no GLN should be provided.

Return Values (Out)

NameCardinalityTypeDocumentation
return1..1Binary

The Binary resource containes a Base64 encoded PDF file which includes a list of all prescriptions with status "active" if the patient has a dose dispesing consent.

Can be invoked with an HTTP POST or GET. This operation can only be invoked on a patient with a dose dispensing consent. The operation is invoked on a Patient resource and initiates the creation of a pdf report which includes the selected patient's all prescriptions, both dose dispensed and ordinary packaged prescriptions. NB! The response containes a Binary resource without the parameter format

Example POST [base]/Patient/[id]/$print-prescriptions