StructureDefinition UKCore-Patient

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patientactive2.6.12024-07-23

This profile defines the UK constraints and extensions on the International FHIR resource Patient.


Profile_Purpose

This profile allows exchange of demographics and other administrative information about an individual receiving care or other health-related services.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueAddressAddress
birthSexI0..1Extension(CodeableConcept)
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
contactPreferenceI0..1Extension(Complex)
deathNotificationStatusI0..1Extension(Complex)
ethnicCategoryI0..1Extension(CodeableConcept)
fetalStatusI0..1Extension(code)
residentialStatusI0..1Extension(CodeableConcept)
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
nhsNumberUnavailableReasonI0..1Extension(CodeableConcept)
modifierExtension?! I0..*Extension
id0..1string
nhsNumberVerificationStatusI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeS Σ ?!0..1boolean
nameS Σ0..*HumanName
id0..1string
extensionI0..*Extension
id0..1string
otherContactSystemI0..1Extension(CodeableConcept)
value0..1System.String
valueΣ0..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderS Σ0..1codeBinding
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueDateTimedateTime
value0..1System.Date
deceasedBooleanboolean
deceasedDateTimedateTime
id0..1string
addressKeyI0..*Extension(Complex)
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
contactRankI0..1Extension(positiveInt)
copyCorrespondenceIndicatorI0..1Extension(boolean)
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
id0..1string
extensionI0..*Extension
id0..1string
otherContactSystemI0..1Extension(CodeableConcept)
value0..1System.String
valueΣ0..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueCodingCoding
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueCodingCoding
url1..1uriFixed Value
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationS Σ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding

Detailed Descriptions

Patient
DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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
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
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.

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
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.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:birthPlace
DefinitionThe registered place of birth of the patient.
Cardinality0...1
TypeExtension(Address)
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
Patient.extension:birthPlace.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:birthPlace.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...0
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:birthPlace.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://hl7.org/fhir/StructureDefinition/patient-birthPlace

Mappings
  • rim: N/A
Patient.extension:birthPlace.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeAddress
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:birthSex
DefinitionThe patient's phenotypic sex at birth.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.extension:cadavericDonor
DefinitionFlag indicating whether the patient authorized the donation of body parts after death.
Cardinality0...1
TypeExtension(boolean)
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
Patient.extension:cadavericDonor.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:cadavericDonor.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...0
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:cadavericDonor.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://hl7.org/fhir/StructureDefinition/patient-cadavericDonor

Mappings
  • rim: N/A
Patient.extension:cadavericDonor.value[x]
DefinitionFlag indicating whether the patient authorized the donation of body parts after death.
Cardinality1...1
Typeboolean
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:contactPreference
DefinitionThe preferred method of contact, contact times and written communication format given by a Patient or Related Person.
Cardinality0...1
TypeExtension(Complex)
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
Patient.extension:deathNotificationStatus
DefinitionThe patient's death notification status.
Cardinality0...1
TypeExtension(Complex)
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
Patient.extension:ethnicCategory
DefinitionThe ethnicity of the subject.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.extension:fetalStatus
DefinitionTypically used in maternity where the patient record may be created before the birth of the baby.
Cardinality0...1
TypeExtension(code)
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
Patient.extension:residentialStatus
DefinitionThe residential status of the patient. For example if this patient is a UK resident.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.extension:patientInterpreterRequired
DefinitionThis Patient requires an interpreter to communicate healthcare information to the practitioner.
Cardinality0...1
TypeExtension(boolean)
Aliasextensions, user content
Comments

The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required.

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:patientInterpreterRequired.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:patientInterpreterRequired.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...0
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:patientInterpreterRequired.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://hl7.org/fhir/StructureDefinition/patient-interpreterRequired

Mappings
  • rim: N/A
Patient.extension:patientInterpreterRequired.value[x]
DefinitionIndicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner.
Cardinality1...1
Typeboolean
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:nhsNumberUnavailableReason
DefinitionThe reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.
Cardinality0...1
TypeExtension(CodeableConcept)
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
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
DefinitionAn identifier for this patient.
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:nhsNumber
DefinitionAn identifier for this patient.
Cardinality0...1
TypeIdentifier
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
Patient.identifier:nhsNumber.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:nhsNumber.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:nhsNumber.extension:nhsNumberVerificationStatus
DefinitionThe verification/tracing status of the NHS number.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.identifier:nhsNumber.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:nhsNumber.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:nhsNumber.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
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

https://fhir.nhs.uk/Id/nhs-number

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Patient.identifier:nhsNumber.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
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())
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:nhsNumber.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:nhsNumber.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
Patient.name
DefinitionA name associated with the individual.
Cardinality0...*
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.telecom
DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Cardinality0...*
TypeContactPoint
Must SupportTrue
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.telecom.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.telecom.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.telecom.system
DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact.
Cardinality0...1
Typecode
Binding

Telecommunications form for contact point.

ContactPointSystem (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
  • v2: XTN.3
  • rim: ./scheme
  • servd: ./ContactPointType
Patient.telecom.system.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.telecom.system.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.telecom.system.extension:otherContactSystem
DefinitionOther contact system value which extends the system element in the ContactPoint datatype.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.telecom.system.value
DefinitionPrimitive value for code
Cardinality0...1
TypeSystem.String
Patient.telecom.value
DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XTN.1 (or XTN.12)
  • rim: ./url
  • servd: ./Value
Patient.telecom.use
DefinitionIdentifies the purpose for the contact point.
Cardinality0...1
Typecode
Binding

Use of contact point.

ContactPointUse (required)
ModifierTrue
SummaryTrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact 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: XTN.2 - but often indicated by field
  • rim: unique(./use)
  • servd: ./ContactPointPurpose
Patient.telecom.rank
DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Cardinality0...1
TypepositiveInt
SummaryTrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

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
Patient.telecom.period
DefinitionTime period when the contact point was/is in 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: N/A
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
Patient.gender
DefinitionAdministrative Gender - the gender that the patient 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)
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
Patient.birthDate
DefinitionThe date of birth for the individual.
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
Patient.birthDate.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.birthDate.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.birthDate.extension:birthTime
DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
Cardinality0...1
TypeExtension(dateTime)
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
Patient.birthDate.extension:birthTime.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.birthDate.extension:birthTime.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...0
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.birthDate.extension:birthTime.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://hl7.org/fhir/StructureDefinition/patient-birthTime

Mappings
  • rim: N/A
Patient.birthDate.extension:birthTime.value[x]
DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
Cardinality1...1
TypedateTime
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.birthDate.value
DefinitionPrimitive value for date
Cardinality0...1
TypeSystem.Date
Patient.deceased[x]
DefinitionIndicates if the individual is deceased or not.
Cardinality0...1
Typeboolean
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. Most systems will interpret the absence of a value as a sign of the person being alive.

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
Patient.address
DefinitionAn address for the individual.
Cardinality0...*
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
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:addressKey
DefinitionA patient's address key and type.
Cardinality0...*
TypeExtension(Complex)
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
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

An indicator to identify the legal marital status of a person

UKCorePersonMaritalStatusCode (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.extension:contactRank
DefinitionThe preferred ranking or order of contact applied to a contact on a patient's contact list.
Cardinality0...1
TypeExtension(positiveInt)
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
Patient.contact.extension:copyCorrespondenceIndicator
DefinitionExtension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence.
Cardinality0...1
TypeExtension(boolean)
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
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.

UKCorePersonRelationshipType (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.telecom.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.telecom.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.telecom.system
DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact.
Cardinality0...1
Typecode
Binding

Telecommunications form for contact point.

ContactPointSystem (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
  • v2: XTN.3
  • rim: ./scheme
  • servd: ./ContactPointType
Patient.contact.telecom.system.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.telecom.system.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.telecom.system.extension:otherContactSystem
DefinitionOther contact system value which extends the system element in the ContactPoint datatype.
Cardinality0...1
TypeExtension(CodeableConcept)
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
Patient.contact.telecom.system.value
DefinitionPrimitive value for code
Cardinality0...1
TypeSystem.String
Patient.contact.telecom.value
DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: XTN.1 (or XTN.12)
  • rim: ./url
  • servd: ./Value
Patient.contact.telecom.use
DefinitionIdentifies the purpose for the contact point.
Cardinality0...1
Typecode
Binding

Use of contact point.

ContactPointUse (required)
ModifierTrue
SummaryTrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact 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: XTN.2 - but often indicated by field
  • rim: unique(./use)
  • servd: ./ContactPointPurpose
Patient.contact.telecom.rank
DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Cardinality0...1
TypepositiveInt
SummaryTrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

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
Patient.contact.telecom.period
DefinitionTime period when the contact point was/is in 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: N/A
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
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.extension:proficiency
DefinitionProficiency level of the communication.
Cardinality0...1
TypeExtension(Complex)
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
Patient.communication.extension:proficiency.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:proficiency.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.extension:proficiency.extension:level
DefinitionHow well the patient can communicate this communication (good, poor, etc.).
Cardinality0...1
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.

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.extension:proficiency.extension:level.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:proficiency.extension:level.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...0
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.extension:proficiency.extension:level.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

level

Mappings
  • rim: N/A
Patient.communication.extension:proficiency.extension:level.value[x]
DefinitionThe proficiency level for the communication.
Cardinality1...1
TypeCoding
Binding

The proficiency level for the communication.

v3.LanguageAbilityProficiency (preferred)
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.communication.extension:proficiency.extension:type
DefinitionWhat type of communication for the proficiency (spoken, written, etc.).
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.

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.extension:proficiency.extension:type.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:proficiency.extension:type.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...0
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.extension:proficiency.extension:type.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

type

Mappings
  • rim: N/A
Patient.communication.extension:proficiency.extension:type.value[x]
DefinitionThe proficiency type for the communication.
Cardinality1...1
TypeCoding
Binding

The proficiency type for the communication.

v3.LanguageAbilityMode (preferred)
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.communication.extension:proficiency.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://hl7.org/fhir/StructureDefinition/patient-proficiency

Mappings
  • rim: N/A
Patient.communication.extension:proficiency.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
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.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
DefinitionA ValueSet that identifies the language used by a person.
Cardinality1...1
TypeCodeableConcept
Binding

A ValueSet that identifies the language used by a person.

AllLanguages (required)
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)
Must SupportTrue
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

Table View

Patient..
Patient.extensionExtension..
Patient.extension.value[x]..
Patient.extensionExtension..
Patient.extensionExtension..
Patient.extension.value[x]..
Patient.extensionExtension..
Patient.extensionExtension..
Patient.extensionExtension..1
Patient.extensionExtension..
Patient.extensionExtension..
Patient.extensionExtension..
Patient.extension.value[x]..
Patient.extensionExtension..
Patient.identifier..
Patient.identifier..1
Patient.identifier.extensionExtension..1
Patient.identifier.system1..
Patient.identifier.value1..
Patient.active..
Patient.name..
Patient.telecom..
Patient.telecom.system..
Patient.telecom.system.extensionExtension..
Patient.gender..
Patient.birthDate..
Patient.birthDate.extensionExtension..
Patient.birthDate.extension.value[x]..
Patient.address..
Patient.address.extensionExtension..
Patient.maritalStatus..
Patient.contact..
Patient.contact.extensionExtension..
Patient.contact.extensionExtension..
Patient.contact.relationship..
Patient.contact.telecom..
Patient.contact.telecom.system..
Patient.contact.telecom.system.extensionExtension..
Patient.communication..
Patient.communication.extensionExtension..1
Patient.communication.extension.extension..
Patient.communication.extension.extension.value[x]..
Patient.communication.extension.extension..
Patient.communication.extension.extension.value[x]..
Patient.communication.language..
Patient.managingOrganization..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Patient" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
    <version value="2.6.1" />
    <name value="UKCorePatient" />
    <title value="UK Core Patient" />
    <status value="active" />
    <date value="2024-07-23" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Patient](https://hl7.org/fhir/R4/Patient.html)." />
    <purpose value="This profile allows exchange of demographics and other administrative information about an individual receiving care or other health-related services." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Patient" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
    <derivation value="constraint" />
    <differential>
        <element id="Patient.extension:birthPlace">
            <path value="Patient.extension" />
            <sliceName value="birthPlace" />
            <short value="The registered place of birth of the patient." />
            <definition value="The registered place of birth of the patient." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-birthPlace" />
            </type>
        </element>
        <element id="Patient.extension:birthPlace.value[x]">
            <path value="Patient.extension.value[x]" />
            <short value="The registered place of birth of the patient." />
        </element>
        <element id="Patient.extension:birthSex">
            <path value="Patient.extension" />
            <sliceName value="birthSex" />
            <short value="The patient&#39;s phenotypic sex at birth." />
            <definition value="The patient&#39;s phenotypic sex at birth." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex" />
            </type>
        </element>
        <element id="Patient.extension:cadavericDonor">
            <path value="Patient.extension" />
            <sliceName value="cadavericDonor" />
            <short value="Post-mortem donor status." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor" />
            </type>
        </element>
        <element id="Patient.extension:cadavericDonor.value[x]">
            <path value="Patient.extension.value[x]" />
            <short value="Post-mortem donor status." />
            <definition value="Flag indicating whether the patient authorized the donation of body parts after death." />
        </element>
        <element id="Patient.extension:contactPreference">
            <path value="Patient.extension" />
            <sliceName value="contactPreference" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference" />
            </type>
        </element>
        <element id="Patient.extension:deathNotificationStatus">
            <path value="Patient.extension" />
            <sliceName value="deathNotificationStatus" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus" />
            </type>
        </element>
        <element id="Patient.extension:ethnicCategory">
            <path value="Patient.extension" />
            <sliceName value="ethnicCategory" />
            <short value="The ethnicity of the subject." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory" />
            </type>
        </element>
        <element id="Patient.extension:fetalStatus">
            <path value="Patient.extension" />
            <sliceName value="fetalStatus" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Patient.extension:residentialStatus">
            <path value="Patient.extension" />
            <sliceName value="residentialStatus" />
            <short value="The residential status of the patient." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus" />
            </type>
        </element>
        <element id="Patient.extension:patientInterpreterRequired">
            <path value="Patient.extension" />
            <sliceName value="patientInterpreterRequired" />
            <short value="Indicator showing whether the patient needs an interpreter." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired" />
            </type>
        </element>
        <element id="Patient.extension:patientInterpreterRequired.value[x]">
            <path value="Patient.extension.value[x]" />
            <short value="Indicator showing whether the patient needs an interpreter" />
            <definition value="Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner." />
        </element>
        <element id="Patient.extension:nhsNumberUnavailableReason">
            <path value="Patient.extension" />
            <sliceName value="nhsNumberUnavailableReason" />
            <short value="Reason why this Patient does not include an NHS Number identifier." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="An identifier for this patient." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:nhsNumber">
            <path value="Patient.identifier" />
            <sliceName value="nhsNumber" />
            <short value="The patient&#39;s NHS number." />
            <max value="1" />
            <mustSupport value="false" />
        </element>
        <element id="Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus">
            <path value="Patient.identifier.extension" />
            <sliceName value="nhsNumberVerificationStatus" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus" />
            </type>
            <mustSupport value="false" />
        </element>
        <element id="Patient.identifier:nhsNumber.system">
            <path value="Patient.identifier.system" />
            <min value="1" />
            <fixedUri value="https://fhir.nhs.uk/Id/nhs-number" />
        </element>
        <element id="Patient.identifier:nhsNumber.value">
            <path value="Patient.identifier.value" />
            <min value="1" />
        </element>
        <element id="Patient.active">
            <path value="Patient.active" />
            <short value="Whether this patient&#39;s record is in active use." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <short value="A name associated with the patient." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom">
            <path value="Patient.telecom" />
            <short value="A contact detail for the individual." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.system.extension:otherContactSystem">
            <path value="Patient.telecom.system.extension" />
            <sliceName value="otherContactSystem" />
            <short value="Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem" />
            </type>
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <short value="The gender that the patient is considered to have for administration and record keeping purposes." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <short value="The date of birth for the individual." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.birthDate.extension:birthTime">
            <path value="Patient.birthDate.extension" />
            <sliceName value="birthTime" />
            <short value="The time of day that the patient was born. This SHOULD be included when the birth time is relevant." />
            <definition value="The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-birthTime" />
            </type>
        </element>
        <element id="Patient.birthDate.extension:birthTime.value[x]">
            <path value="Patient.birthDate.extension.value[x]" />
            <short value="Time of day of birth." />
            <definition value="The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively." />
        </element>
        <element id="Patient.address">
            <path value="Patient.address" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.extension:addressKey">
            <path value="Patient.address.extension" />
            <sliceName value="addressKey" />
            <short value="A patient&#39;s address key and type" />
            <definition value="A patient&#39;s address key and type." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey" />
            </type>
            <mustSupport value="false" />
        </element>
        <element id="Patient.maritalStatus">
            <path value="Patient.maritalStatus" />
            <binding>
                <strength value="extensible" />
                <description value="An indicator to identify the legal marital status of a person" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-PersonMaritalStatusCode" />
            </binding>
        </element>
        <element id="Patient.contact.extension:contactRank">
            <path value="Patient.contact.extension" />
            <sliceName value="contactRank" />
            <short value="The preferred ranking or order of contact applied to a contact on a Patient&#39;s contact list." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank" />
            </type>
        </element>
        <element id="Patient.contact.extension:copyCorrespondenceIndicator">
            <path value="Patient.contact.extension" />
            <sliceName value="copyCorrespondenceIndicator" />
            <short value="Indicates that a must be copied in to all related correspondence." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator" />
            </type>
        </element>
        <element id="Patient.contact.relationship">
            <path value="Patient.contact.relationship" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType" />
            </binding>
        </element>
        <element id="Patient.contact.telecom.system.extension:otherContactSystem">
            <path value="Patient.contact.telecom.system.extension" />
            <sliceName value="otherContactSystem" />
            <short value="Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem" />
            </type>
        </element>
        <element id="Patient.communication.extension:proficiency">
            <path value="Patient.communication.extension" />
            <sliceName value="proficiency" />
            <short value="The patient&#39;s proficiency level of the communication method." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-proficiency" />
            </type>
        </element>
        <element id="Patient.communication.extension:proficiency.extension:level">
            <path value="Patient.communication.extension.extension" />
            <sliceName value="level" />
        </element>
        <element id="Patient.communication.extension:proficiency.extension:level.value[x]">
            <path value="Patient.communication.extension.extension.value[x]" />
            <short value="The proficiency level for the communication" />
            <definition value="The proficiency level for the communication." />
        </element>
        <element id="Patient.communication.extension:proficiency.extension:type">
            <path value="Patient.communication.extension.extension" />
            <sliceName value="type" />
        </element>
        <element id="Patient.communication.extension:proficiency.extension:type.value[x]">
            <path value="Patient.communication.extension.extension.value[x]" />
            <short value="The proficiency type for the communication" />
            <definition value="The proficiency type for the communication." />
        </element>
        <element id="Patient.communication.language">
            <path value="Patient.communication.language" />
            <short value="A ValueSet that identifies the language used by a person." />
            <definition value="A ValueSet that identifies the language used by a person." />
            <binding>
                <strength value="required" />
                <description value="A ValueSet that identifies the language used by a person." />
                <valueSet value="http://hl7.org/fhir/ValueSet/all-languages" />
            </binding>
        </element>
        <element id="Patient.managingOrganization">
            <path value="Patient.managingOrganization" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Patient",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
    "version": "2.6.1",
    "name": "UKCorePatient",
    "title": "UK Core Patient",
    "status": "active",
    "date": "2024-07-23",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Patient](https://hl7.org/fhir/R4/Patient.html).",
    "purpose": "This profile allows exchange of demographics and other administrative information about an individual receiving care or other health-related services.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient.extension:birthPlace",
                "path": "Patient.extension",
                "sliceName": "birthPlace",
                "short": "The registered place of birth of the patient.",
                "definition": "The registered place of birth of the patient.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-birthPlace"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:birthPlace.value[x]",
                "path": "Patient.extension.value[x]",
                "short": "The registered place of birth of the patient."
            },
            {
                "id": "Patient.extension:birthSex",
                "path": "Patient.extension",
                "sliceName": "birthSex",
                "short": "The patient's phenotypic sex at birth.",
                "definition": "The patient's phenotypic sex at birth.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:cadavericDonor",
                "path": "Patient.extension",
                "sliceName": "cadavericDonor",
                "short": "Post-mortem donor status.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:cadavericDonor.value[x]",
                "path": "Patient.extension.value[x]",
                "short": "Post-mortem donor status.",
                "definition": "Flag indicating whether the patient authorized the donation of body parts after death."
            },
            {
                "id": "Patient.extension:contactPreference",
                "path": "Patient.extension",
                "sliceName": "contactPreference",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:deathNotificationStatus",
                "path": "Patient.extension",
                "sliceName": "deathNotificationStatus",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:ethnicCategory",
                "path": "Patient.extension",
                "sliceName": "ethnicCategory",
                "short": "The ethnicity of the subject.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:fetalStatus",
                "path": "Patient.extension",
                "sliceName": "fetalStatus",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Patient.extension:residentialStatus",
                "path": "Patient.extension",
                "sliceName": "residentialStatus",
                "short": "The residential status of the patient.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:patientInterpreterRequired",
                "path": "Patient.extension",
                "sliceName": "patientInterpreterRequired",
                "short": "Indicator showing whether the patient needs an interpreter.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:patientInterpreterRequired.value[x]",
                "path": "Patient.extension.value[x]",
                "short": "Indicator showing whether the patient needs an interpreter",
                "definition": "Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner."
            },
            {
                "id": "Patient.extension:nhsNumberUnavailableReason",
                "path": "Patient.extension",
                "sliceName": "nhsNumberUnavailableReason",
                "short": "Reason why this Patient does not include an NHS Number identifier.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "An identifier for this patient.",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:nhsNumber",
                "path": "Patient.identifier",
                "sliceName": "nhsNumber",
                "short": "The patient's NHS number.",
                "max": "1",
                "mustSupport": false
            },
            {
                "id": "Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus",
                "path": "Patient.identifier.extension",
                "sliceName": "nhsNumberVerificationStatus",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus"
                        ]
                    }
                ],
                "mustSupport": false
            },
            {
                "id": "Patient.identifier:nhsNumber.system",
                "path": "Patient.identifier.system",
                "min": 1,
                "fixedUri": "https://fhir.nhs.uk/Id/nhs-number"
            },
            {
                "id": "Patient.identifier:nhsNumber.value",
                "path": "Patient.identifier.value",
                "min": 1
            },
            {
                "id": "Patient.active",
                "path": "Patient.active",
                "short": "Whether this patient's record is in active use.",
                "mustSupport": true
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "short": "A name associated with the patient.",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "short": "A contact detail for the individual.",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.system.extension:otherContactSystem",
                "path": "Patient.telecom.system.extension",
                "sliceName": "otherContactSystem",
                "short": "Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "short": "The gender that the patient is considered to have for administration and record keeping purposes.",
                "mustSupport": true
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "short": "The date of birth for the individual.",
                "mustSupport": true
            },
            {
                "id": "Patient.birthDate.extension:birthTime",
                "path": "Patient.birthDate.extension",
                "sliceName": "birthTime",
                "short": "The time of day that the patient was born. This SHOULD be included when the birth time is relevant.",
                "definition": "The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-birthTime"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.birthDate.extension:birthTime.value[x]",
                "path": "Patient.birthDate.extension.value[x]",
                "short": "Time of day of birth.",
                "definition": "The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively."
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "mustSupport": true
            },
            {
                "id": "Patient.address.extension:addressKey",
                "path": "Patient.address.extension",
                "sliceName": "addressKey",
                "short": "A patient's address key and type",
                "definition": "A patient's address key and type.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey"
                        ]
                    }
                ],
                "mustSupport": false
            },
            {
                "id": "Patient.maritalStatus",
                "path": "Patient.maritalStatus",
                "binding": {
                    "strength": "extensible",
                    "description": "An indicator to identify the legal marital status of a person",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-PersonMaritalStatusCode"
                }
            },
            {
                "id": "Patient.contact.extension:contactRank",
                "path": "Patient.contact.extension",
                "sliceName": "contactRank",
                "short": "The preferred ranking or order of contact applied to a contact on a Patient's contact list.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.contact.extension:copyCorrespondenceIndicator",
                "path": "Patient.contact.extension",
                "sliceName": "copyCorrespondenceIndicator",
                "short": "Indicates that a must be copied in to all related correspondence.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.contact.relationship",
                "path": "Patient.contact.relationship",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType"
                }
            },
            {
                "id": "Patient.contact.telecom.system.extension:otherContactSystem",
                "path": "Patient.contact.telecom.system.extension",
                "sliceName": "otherContactSystem",
                "short": "Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.communication.extension:proficiency",
                "path": "Patient.communication.extension",
                "sliceName": "proficiency",
                "short": "The patient's proficiency level of the communication method.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-proficiency"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.communication.extension:proficiency.extension:level",
                "path": "Patient.communication.extension.extension",
                "sliceName": "level"
            },
            {
                "id": "Patient.communication.extension:proficiency.extension:level.value[x]",
                "path": "Patient.communication.extension.extension.value[x]",
                "short": "The proficiency level for the communication",
                "definition": "The proficiency level for the communication."
            },
            {
                "id": "Patient.communication.extension:proficiency.extension:type",
                "path": "Patient.communication.extension.extension",
                "sliceName": "type"
            },
            {
                "id": "Patient.communication.extension:proficiency.extension:type.value[x]",
                "path": "Patient.communication.extension.extension.value[x]",
                "short": "The proficiency type for the communication",
                "definition": "The proficiency type for the communication."
            },
            {
                "id": "Patient.communication.language",
                "path": "Patient.communication.language",
                "short": "A ValueSet that identifies the language used by a person.",
                "definition": "A ValueSet that identifies the language used by a person.",
                "binding": {
                    "strength": "required",
                    "description": "A ValueSet that identifies the language used by a person.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/all-languages"
                }
            },
            {
                "id": "Patient.managingOrganization",
                "path": "Patient.managingOrganization",
                "mustSupport": true
            }
        ]
    }
}

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Examples

Address Key - An example to illustrate the use of an address key used with the address datatype.
Example UKCore-Extension-AddressKey

Birth Sex - An example to illustrate the extension for a patient's birth sex.
Example UKCore-Extension-BirthSex

Contact Rank - An example to illustrate the extension for the patient's contact ranking.
Example UKCore-Extension-ContactRank

Contact Preference - An example to illustrate the extension for a patient's contact preferences.
Example UKCore-Extension-ContactPreference

Copy Correspondence Indicator - An Example to illustrate the extension for copy correspondence indicators.
Example UKCore-Extension-CopyCorrespondenceIndicator

Death Notification Status - An example to illustrate the extension to indicate the death notification status of the patient.
Example UKCore-Extension-DeathNotificationStatus

Ethnic Category - An example to illustrate patient Ethnic Category information.
Example UKCore-Extension-EthnicCategory

Melanie Jones - An example of a baby patient.
Example UKCore-Patient-BabyPatient

NHS Number Unavailable Reason- An example of the extension which states the reason a patient's NHS number is unavailable.
Example UKCore-Extension-NHSNumberUnavailableReason

NHS Number Verification Status - An example of the extension which states the patient's NHS number verification status.
Example UKCore-Extension-NHSNumberVerificationStatus

Other Contact System - An example to illustrate the extension to indicate other contact system(s) for a patient Richard Smith.
Example UKCore-Extension-OtherContactSystem

Residential Status - An example to illustrate the extension to show the patient's residential status.
Example UKCore-Extension-ResidentialStatus

Richard Smith - An example to illustrate a male patient's demographics.
Example UKCore-Patient-RichardSmith

Example Usage Scenarios

The following are example usage scenarios for the UK Core Patient profile:

  • Query for Patient demographic information using the query parameter Patient.identifier for a known NHS number.
  • Query for Patient demographic information using query parameters such as Patient.name.family, Patient.name.given, Patient.birthDate, and Patient.gender.
  • Exchange Patient demographic information within a FHIR document or message.

Profile Specific Implementation Guidance:

Mandatory and Must Support Data Elements

The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.

ElementReason
Patient.identifierAn identifier for this patient.
Patient.identifierThe patient's NHS number.
Patient.identifier.extension
Patient.activeWhether this patient's record is in active use.
Patient.nameA name associated with the patient.
Patient.telecomA contact detail for the individual.
Patient.genderThe gender that the patient is considered to have for administration and record keeping purposes.
Patient.birthDateThe date of birth for the individual.
Patient.address
Patient.address.extensionA patient's address key and type
Patient.managingOrganization


Extensions

More information about the extensions can be found using the links below.

Extension Context Link Comment
addressKey Patient.address Extension UKCore-AddressKey A patient's address key and type.
birthPlace Patient Core-defined Extension patient-birthPlace The registered place of birth of the patient.
birthSex Patient Extension UKCore-BirthSex The patient's phenotypic sex at birth.
birthTime Patient.birthDate Core-defined Extension patient-birthTime The time of day that the patient was born. This SHOULD be included when the birth time is relevant.
cadavericDonor Patient Core-defined Extension patient-cadavericDonor Post-mortem donor status.
contactPreference Patient Extension UKCore-ContactPreference
contactRank Patient.contact Extension UKCore-ContactRank The preferred ranking or order of contact applied to a contact on a Patient's contact list.
copyCorrespondenceIndicator Patient.contact Extension UKCore-CopyCorrespondenceIndicator Indicates that the contact must be copied in to all related correspondence.
deathNotificationStatus Patient Extension UKCore-DeathNotificationStatus The patient's death notification status.
ethnicCategory Patient Extension UKCore-EthnicCategory The ethnicity of the subject.
nhsNumberUnavailableReason Patient Extension UKCore-NHSNumberUnavailableReason Reason why this Patient does not include an NHS Number identifier.
nhsNumberVerificationStatus Patient.identifier:nhsNumber Extension UKCore-NHSNumberVerificationStatus
otherContactSystem Patient.telecom.system Extension UKCore-OtherContactSystem Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`.
PatientFetalStatus Patient
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to replicate the changes within R5 to record the born status of fetus (Patient)
patientInterpreterRequired Patient Core-defined Extension patient-interpreterRequired Indicator showing whether the patient needs an interpreter.
proficiency Patient.communication Core-defined Extension patient-proficiency The patient's proficiency level of the communication method.
residentialStatus Patient Extension UKCore-ResidentialStatus The residential status of the patient.

Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

Context Strength Link
Patient.extension:birthSex Required ValueSet UKCore-BirthSex
Patient.extension:contactPreference.extension:
PreferredContactMethod
Extensible ValueSet UKCore-PreferredContactMethod
Patient.extension:contactPreference.extension:
PreferredWrittenCommunicationFormat
Extensible ValueSet UKCore-PreferredWrittenCommunicationFormat
Patient.extension:deathNotificationStatus.extension:
deathNotificationStatus
Extensible ValueSet UKCore-DeathNotificationStatus
Patient.extension:ethnicCategory Preferred ValueSet UKCore-EthnicCategory
Patient.extension:nhsNumberUnavailableReason Extensible ValueSet UKCore-NHSNumberUnavailableReason
Patient.extension:residentialStatus Extensible ValueSet UKCore-ResidentialStatus
Patient.address.extension:
addressKey.extension:type
Extensible ValueSet UKCore-AddressKeyType
Patient.communication.language Required Core-defined ValueSet All Languages
Patient.contact.relationship Extensible ValueSet UKCore-PersonRelationshipType
Patient.identifer.nhsNumber.extension:
nhsNumberVerificationStatus
Required ValueSet UKCore-NHSNumberVerificationStatus
Patient.maritalStatus Extensible ValueSet UKCore-PersonMaritalStatusCode

identifier

In England and Wales this SHOULD include the patient's NHS number, where this is not possible then a Medical Records Number (MRN) MAY be used.

If the identifier is an NHS number then the extension Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus SHOULD be populated to indicate the verification status with a code from the ValueSet UKCore-NHSNumberVerificationStatus.


name

The patient name represented by the HumanName data type.

Multiple names can be included.


telecom

Patient.telecom.system has the UKCore extension Extension UKCore-OtherContactSystem.

A contact detail for the person using the ContactPoint data type.


address

The address of the patient using the Address datatype.

A patient may have multiple addresses with different uses or applicable periods.


photo

A photograph relating to a patient. This can be included as either:

  • An attachment encoded as base64Binary with a relevant MIME contentType: image/png, image/jpg or image/jpeg preferred.

Example of Patient.photo usage:

Table View

Patient.id[0]UKCore-Patient-Sn-Photo-Example
Patient.photo[0].contentType[0]image/png
Patient.photo[0].data[0]base64Binary

Tree View

Patient

XML View

<Patient xmlns="http://hl7.org/fhir">
    <id value="UKCore-Patient-Sn-Photo-Example" />
    <!--  **************snippet start**************  -->
    <photo>
        <contentType value="image/png" />
        <data value="base64Binary" />
    </photo>
    <!--  **************snippet end**************  -->
</Patient>

JSON View

{
    "resourceType": "Patient",
    "id": "UKCore-Patient-Sn-Photo-Example",
    "photo":  [
        {
            "contentType": "image/png",
            "data": "base64Binary"
        }
    ]
}

and/or
  • URL where the data can be found.

If both are used, the URL SHALL point to the same data as that encoded in the attachment.


communication

Patient.communication has the Core-defined Extension patient-proficiency.

One or more instances of this element can be used to list the languages the patient is able to communicate in.

The Patient.communication.language element has a Required binding to the Core-defined ValueSet All Languages which is derived from urn:ietf:bcp:47.

An example of a patient with a single language

Table View

Patient.id[0]UKCore-Patient-Sn-SingleLanguage-Example
Patient.name[0].use[0]official
Patient.name[0].family[0]JONES
Patient.name[0].given[0]Jason
Patient.communication[0].language[0].coding[0].system[0]urn:ietf:bcp:47
Patient.communication[0].language[0].coding[0].code[0]en
Patient.communication[0].language[0].coding[0].display[0]English

Tree View

Patient

XML View

<Patient xmlns="http://hl7.org/fhir">
    <id value="UKCore-Patient-Sn-SingleLanguage-Example" />
    <name>
        <use value="official" />
        <family value="JONES" />
        <given value="Jason" />
    </name>
    <communication>
        <language>
            <coding>
                <system value="urn:ietf:bcp:47" />
                <code value="en" />
                <display value="English" />
            </coding>
        </language>
    </communication>
</Patient>

JSON View

{
    "resourceType": "Patient",
    "id": "UKCore-Patient-Sn-SingleLanguage-Example",
    "name":  [
        {
            "use": "official",
            "family": "JONES",
            "given":  [
                "Jason"
            ]
        }
    ],
    "communication":  [
        {
            "language": {
                "coding":  [
                    {
                        "system": "urn:ietf:bcp:47",
                        "code": "en",
                        "display": "English"
                    }
                ]
            }
        }
    ]
}

An example of a patient with multiple languages, with different proficiencies

Table View

Patient.id[0]UKCore-Patient-Sn-MultipleLanguages-Example
Patient.name[0].use[0]official
Patient.name[0].family[0]JONES
Patient.name[0].given[0]Jason
Patient.communication[0].extension[0].extension[0].url[0]level
Patient.communication[0].extension[0].extension[0].value[0].system[0]http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency
Patient.communication[0].extension[0].extension[0].value[0].code[0]E
Patient.communication[0].extension[0].extension[0].value[0].display[0]Excellent
Patient.communication[0].extension[0].url[0]http://hl7.org/fhir/StructureDefinition/patient-proficiency
Patient.communication[0].language[0].coding[0].system[0]urn:ietf:bcp:47
Patient.communication[0].language[0].coding[0].code[0]en
Patient.communication[0].language[0].coding[0].display[0]English
Patient.communication[1].extension[0].extension[0].url[0]level
Patient.communication[1].extension[0].extension[0].value[0].system[0]http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency
Patient.communication[1].extension[0].extension[0].value[0].code[0]P
Patient.communication[1].extension[0].extension[0].value[0].display[0]Poor
Patient.communication[1].extension[0].extension[1].url[0]type
Patient.communication[1].extension[0].extension[1].value[0].system[0]http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode
Patient.communication[1].extension[0].extension[1].value[0].code[0]ESP
Patient.communication[1].extension[0].extension[1].value[0].display[0]Expressed spoken
Patient.communication[1].extension[0].url[0]http://hl7.org/fhir/StructureDefinition/patient-proficiency
Patient.communication[1].language[0].coding[0].system[0]urn:ietf:bcp:47
Patient.communication[1].language[0].coding[0].code[0]fr
Patient.communication[1].language[0].coding[0].display[0]French

Tree View

Patient

XML View

<Patient xmlns="http://hl7.org/fhir">
    <id value="UKCore-Patient-Sn-MultipleLanguages-Example" />
    <name>
        <use value="official" />
        <family value="JONES" />
        <given value="Jason" />
    </name>
    <communication>
        <extension url="http://hl7.org/fhir/StructureDefinition/patient-proficiency">
            <extension url="level">
                <valueCoding>
                    <system value="http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency" />
                    <code value="E" />
                    <display value="Excellent" />
                </valueCoding>
            </extension>
        </extension>
        <language>
            <coding>
                <system value="urn:ietf:bcp:47" />
                <code value="en" />
                <display value="English" />
            </coding>
        </language>
    </communication>
    <communication>
        <extension url="http://hl7.org/fhir/StructureDefinition/patient-proficiency">
            <extension url="level">
                <valueCoding>
                    <system value="http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency" />
                    <code value="P" />
                    <display value="Poor" />
                </valueCoding>
            </extension>
            <extension url="type">
                <valueCoding>
                    <system value="http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode" />
                    <code value="ESP" />
                    <display value="Expressed spoken" />
                </valueCoding>
            </extension>
        </extension>
        <language>
            <coding>
                <system value="urn:ietf:bcp:47" />
                <code value="fr" />
                <display value="French" />
            </coding>
        </language>
    </communication>
</Patient>

JSON View

{
    "resourceType": "Patient",
    "id": "UKCore-Patient-Sn-MultipleLanguages-Example",
    "name":  [
        {
            "use": "official",
            "family": "JONES",
            "given":  [
                "Jason"
            ]
        }
    ],
    "communication":  [
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "url": "level",
                            "valueCoding": {
                                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
                                "code": "E",
                                "display": "Excellent"
                            }
                        }
                    ],
                    "url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency"
                }
            ],
            "language": {
                "coding":  [
                    {
                        "system": "urn:ietf:bcp:47",
                        "code": "en",
                        "display": "English"
                    }
                ]
            }
        },
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "url": "level",
                            "valueCoding": {
                                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
                                "code": "P",
                                "display": "Poor"
                            }
                        },
                        {
                            "url": "type",
                            "valueCoding": {
                                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode",
                                "code": "ESP",
                                "display": "Expressed spoken"
                            }
                        }
                    ],
                    "url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency"
                }
            ],
            "language": {
                "coding":  [
                    {
                        "system": "urn:ietf:bcp:47",
                        "code": "fr",
                        "display": "French"
                    }
                ]
            }
        }
    ]
}

An example of a patient with British Sign Language and Makaton

Table View

Patient.id[0]UKCore-Patient-Sn-Makaton-Example
Patient.name[0].use[0]official
Patient.name[0].family[0]JONES
Patient.name[0].given[0]Jason
Patient.communication[0].language[0].coding[0].system[0]urn:ietf:bcp:47
Patient.communication[0].language[0].coding[0].code[0]bfi
Patient.communication[0].language[0].coding[0].display[0]British Sign Language
Patient.communication[0].language[0].coding[1].system[0]http://snomed.info/sct
Patient.communication[0].language[0].coding[1].code[0]703963007
Patient.communication[0].language[0].coding[1].display[0]Makaton vocabulary

Tree View

Patient

XML View

<Patient xmlns="http://hl7.org/fhir">
    <id value="UKCore-Patient-Sn-Makaton-Example" />
    <name>
        <use value="official" />
        <family value="JONES" />
        <given value="Jason" />
    </name>
    <communication>
        <language>
            <coding>
                <system value="urn:ietf:bcp:47" />
                <code value="bfi" />
                <display value="British Sign Language" />
            </coding>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="703963007" />
                <display value="Makaton vocabulary" />
            </coding>
        </language>
    </communication>
</Patient>

JSON View

{
    "resourceType": "Patient",
    "id": "UKCore-Patient-Sn-Makaton-Example",
    "name":  [
        {
            "use": "official",
            "family": "JONES",
            "given":  [
                "Jason"
            ]
        }
    ],
    "communication":  [
        {
            "language": {
                "coding":  [
                    {
                        "system": "urn:ietf:bcp:47",
                        "code": "bfi",
                        "display": "British Sign Language"
                    },
                    {
                        "system": "http://snomed.info/sct",
                        "code": "703963007",
                        "display": "Makaton vocabulary"
                    }
                ]
            }
        }
    ]
}

NOTE: Makaton is a communication tool with speech, signs, and symbols to enable people with disabilities or learning disabilities to communicate. As such, it is not recognised as a language in urn:ietf:bcp:47, and should be populated as a CodeableConcept.coding element alongside the urn:ietf:bcp:47 parent language from which its country specific adaptation is derived.

managingOrganization

An Organization that is the custodian of the patient record (such as a general practice).

The Patient.managingOrganization may change according to the setting (a mental health record may be managed by a MH trust), whereas the Patient.generalPractitioner points to your GP or GP Practice.


generalPractitioner

The patient's GP by reference to Practitioner which SHOULD conform to Profile UKCore-Practitioner for the GP and/or Profile UKCore-Organization for the patient's GP practice.

Where possible, it is expected that the resource being referenced SHOULD conform to a UK Core profile.