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    1. Home
    2. FHIR Artifacts
    3. Extensions
    4. BirthSex

Draft preBallot - This specification is under preBallot review and subject to change. It should not be used for implementation purposes. . . . . For a full list of available versions, see the Directory of published versions

BirthSex

Links

Extension

ext-patientbirthsex

Description

A code classifying the person's sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability.

References to this Extension

PatientCACore

Resource Content

  • Overview
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  • XML
  • JSON
ExtensionBirthSex (Extension)Extension
There are no (further) constraints on this element
Element id

Extension

Definition

A code classifying the person's sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability.

Comments

The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

Data type

Extension

Mappings
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • iso11179: .patient.administrativeGenderCode
urlSFixed Value
There are no (further) constraints on this element
Element id

Extension.url

Fixed value

http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex

valueCodingS1..
There are no (further) constraints on this element
Element id

Extension.valueCoding

Binding

Code for sex assigned at birth

BirthSex (example)

system1..
There are no (further) constraints on this element
Element id

Extension.valueCoding.system

code1..
There are no (further) constraints on this element
Element id

Extension.valueCoding.code

display
There are no (further) constraints on this element
Element id

Extension.valueCoding.display

Short description

Optional description of the sex at birth code

Definition

Plain text representation of the sex at birth concept

ExtensionBirthSex (Extension)IExtensionElement id

Extension

Short description

Optional Extensions Element

Definition

A code classifying the person's sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability.

Comments

The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • iso11179: .patient.administrativeGenderCode
id0..1string
There are no (further) constraints on this element
Element id

Extension.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

Extension.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Comments

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

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • 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
urlS1..1uriFixed ValueElement id

Extension.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

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

Data type

uri

Fixed value

http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex

Mappings
  • rim: N/A
value[x]0..1
There are no (further) constraints on this element
Element id

Extension.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Sliced:

Unordered, Open, by $this(Type)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
(All Slices)
There are no (further) constraints on this element
valueBase64Binarybase64Binary
There are no (further) constraints on this element
Data type

base64Binary

valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCanonicalcanonical()
There are no (further) constraints on this element
Data type

canonical()

valueCodecode
There are no (further) constraints on this element
Data type

code

valueDatedate
There are no (further) constraints on this element
Data type

date

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueDecimaldecimal
There are no (further) constraints on this element
Data type

decimal

valueIdid
There are no (further) constraints on this element
Data type

id

valueInstantinstant
There are no (further) constraints on this element
Data type

instant

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valueMarkdownmarkdown
There are no (further) constraints on this element
Data type

markdown

valueOidoid
There are no (further) constraints on this element
Data type

oid

valuePositiveIntpositiveInt
There are no (further) constraints on this element
Data type

positiveInt

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueUnsignedIntunsignedInt
There are no (further) constraints on this element
Data type

unsignedInt

valueUriuri
There are no (further) constraints on this element
Data type

uri

valueUrlurl
There are no (further) constraints on this element
Data type

url

valueUuiduuid
There are no (further) constraints on this element
Data type

uuid

valueAddressAddress
There are no (further) constraints on this element
Data type

Address

valueAgeAge
There are no (further) constraints on this element
Data type

Age

valueAnnotationAnnotation
There are no (further) constraints on this element
Data type

Annotation

valueAttachmentAttachment
There are no (further) constraints on this element
Data type

Attachment

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueContactPointContactPoint
There are no (further) constraints on this element
Data type

ContactPoint

valueCountCount
There are no (further) constraints on this element
Data type

Count

valueDistanceDistance
There are no (further) constraints on this element
Data type

Distance

valueDurationDuration
There are no (further) constraints on this element
Data type

Duration

valueHumanNameHumanName
There are no (further) constraints on this element
Data type

HumanName

valueIdentifierIdentifier
There are no (further) constraints on this element
Data type

Identifier

valueMoneyMoney
There are no (further) constraints on this element
Data type

Money

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueSignatureSignature
There are no (further) constraints on this element
Data type

Signature

valueTimingTiming
There are no (further) constraints on this element
Data type

Timing

valueContactDetailContactDetail
There are no (further) constraints on this element
Data type

ContactDetail

valueContributorContributor
There are no (further) constraints on this element
Data type

Contributor

valueDataRequirementDataRequirement
There are no (further) constraints on this element
Data type

DataRequirement

valueExpressionExpression
There are no (further) constraints on this element
Data type

Expression

valueParameterDefinitionParameterDefinition
There are no (further) constraints on this element
Data type

ParameterDefinition

valueRelatedArtifactRelatedArtifact
There are no (further) constraints on this element
Data type

RelatedArtifact

valueTriggerDefinitionTriggerDefinition
There are no (further) constraints on this element
Data type

TriggerDefinition

valueUsageContextUsageContext
There are no (further) constraints on this element
Data type

UsageContext

valueDosageDosage
There are no (further) constraints on this element
Data type

Dosage

valueMetaMeta
There are no (further) constraints on this element
Data type

Meta

valueReferenceReference()
There are no (further) constraints on this element
Data type

Reference()

valueCodingS1..1CodingElement id

Extension.value[x]:valueCoding

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Data type

Coding

Binding

Code for sex assigned at birth

BirthSex (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
id0..1string
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Comments

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

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • 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
systemΣ1..1uri
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

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

Comments

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

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1code
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1stringElement id

Extension.value[x]:valueCoding.display

Short description

Optional description of the sex at birth code

Definition

Plain text representation of the sex at birth concept

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id

Extension.value[x]:valueCoding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

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

Comments

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

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="ext-patientbirthsex" />
    <text>
        <status value="extensions" />
        --- We have skipped the narrative for better readability of the resource ---
    </text>
    <url value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex" />
    <version value="0.2.0" />
    <name value="ExtensionBirthSex" />
    <title value="Extension: Birth Sex" />
    <status value="draft" />
    <date value="2023-12-15" />
    <publisher value="HL7 Canada - FHIR Implementation Work Group" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="https://infocentral.infoway-inforoute.ca/en/collaboration/wg/fhir-implementations" />
        </telecom>
    </contact>
    <description value="A code classifying the person&#39;s sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability." />
    <jurisdiction>
        <coding>
            <system value="urn:iso:std:iso:3166" />
            <code value="CA" />
        </coding>
    </jurisdiction>
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Patient" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <definition value="A code classifying the person&#39;s sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability." />
            <comment value="The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex." />
            <max value="1" />
            <isModifier value="false" />
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
            </mapping>
            <mapping>
                <identity value="iso11179" />
                <map value=".patient.administrativeGenderCode" />
            </mapping>
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.valueCoding">
            <path value="Extension.valueCoding" />
            <min value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="example" />
                <description value="Code for sex assigned at birth" />
                <valueSet value="http://hl7.org/fhir/ca/baseline/ValueSet/birthsex" />
            </binding>
        </element>
        <element id="Extension.valueCoding.system">
            <path value="Extension.valueCoding.system" />
            <min value="1" />
        </element>
        <element id="Extension.valueCoding.code">
            <path value="Extension.valueCoding.code" />
            <min value="1" />
        </element>
        <element id="Extension.valueCoding.display">
            <path value="Extension.valueCoding.display" />
            <short value="Optional description of the sex at birth code" />
            <definition value="Plain text representation of the sex at birth concept" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "ext-patientbirthsex",
    "text": {
        "status": "extensions",
        --- We have skipped the narrative for better readability of the resource ---
    },
    "url": "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex",
    "version": "0.2.0",
    "name": "ExtensionBirthSex",
    "title": "Extension: Birth Sex",
    "status": "draft",
    "date": "2023-12-15",
    "publisher": "HL7 Canada - FHIR Implementation Work Group",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://infocentral.infoway-inforoute.ca/en/collaboration/wg/fhir-implementations"
                }
            ]
        }
    ],
    "description": "A code classifying the person's sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability.",
    "jurisdiction":  [
        {
            "coding":  [
                {
                    "system": "urn:iso:std:iso:3166",
                    "code": "CA"
                }
            ]
        }
    ],
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        }
    ],
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Patient"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "definition": "A code classifying the person's sex assigned at birth. Replicates the birthsex extension in US-Core-R4 for interoperability.",
                "comment": "The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.",
                "max": "1",
                "isModifier": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
                    },
                    {
                        "identity": "iso11179",
                        "map": ".patient.administrativeGenderCode"
                    }
                ]
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex",
                "mustSupport": true
            },
            {
                "id": "Extension.valueCoding",
                "path": "Extension.valueCoding",
                "min": 1,
                "mustSupport": true,
                "binding": {
                    "strength": "example",
                    "description": "Code for sex assigned at birth",
                    "valueSet": "http://hl7.org/fhir/ca/baseline/ValueSet/birthsex"
                }
            },
            {
                "id": "Extension.valueCoding.system",
                "path": "Extension.valueCoding.system",
                "min": 1
            },
            {
                "id": "Extension.valueCoding.code",
                "path": "Extension.valueCoding.code",
                "min": 1
            },
            {
                "id": "Extension.valueCoding.display",
                "path": "Extension.valueCoding.display",
                "short": "Optional description of the sex at birth code",
                "definition": "Plain text representation of the sex at birth concept"
            }
        ]
    }
}

Terminology bindings

PathConformanceValueSet
Extension.value[x]:valueCodingexamplehttps://fhir.infoway-inforoute.ca/ValueSet/sexassignedatbirth

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