CA Core+ 1.0.0 DFT-preBallot

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

Patient (CA-Core)

Description

This profile applies constraints to the Patient resource for CA Core+ to support identity, demographics, and administrative data in the pan-Canadian context.

References to this resource

AllergyIntoleranceCACore, CommunicationCACore, ConditionCACore, DiagnosticReportCACore, DocumentReferenceCACore, EncounterCACore, FamilyMemberHistoryCACore, ImagingStudyCACore, ImmunizationCACore, MedicationRequestCACore, MedicationStatementCACore, ObservationAlcoholUseCACore, ObservationCACore, ObservationLaboratoryResultCACore, ObservationPathologyCACore, ObservationResultsRadiologyCACore, ObservationSexualOrientation, ObservationSocialHistoryCACore, ObservationTobaccoUseCACore, ServiceRequestCACore, TaskCACore

Resource Content

PatientCACore (Patient)	I		Patient	There are no (further) constraints on this element Element id Patient Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole pCHDCF-CACDI: Patient pCHDCF-CACDI: Person*
id	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These 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. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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) 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
indigenousIdentity	I	0..*	Extension(CodeableConcept)	There are no (further) constraints on this element Element id Patient.extension:indigenousIdentity Short description Extension for representing a code classifying a person's indigenous identity. Alternate names extensions, user content Definition A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type Extension(CodeableConcept) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core 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 pCHDCF-CACDI: Person Indigenous Identity
racializedGroup	I	0..*	Extension(CodeableConcept)	There are no (further) constraints on this element Element id Patient.extension:racializedGroup Short description Extension for representing a code classifying a person's racialized group. Alternate names extensions, user content Definition A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type Extension(CodeableConcept) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core 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 pCHDCF-CACDI: Person Racialized Group
recordedSexOrGender	I	0..*	Extension(Complex)	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender Short description Recorded sex or gender (RSG) information includes the various sex and gender concepts. Alternate names extensions, user content Definition Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. 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(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender 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
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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 id Mappings rim: n/a
extension	I	1..*	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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 managable, 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
value	I	1..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value Short description The recorded sex or gender property for the individual Definition A sex or gender property for the individual from a document or other record 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.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 value Mappings rim: N/A
value[x]	I	1..1	Binding	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.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). Binding RecordedGenderValueSet (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
type	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type Short description Type of recorded sex or gender. Definition The type or category of sex or gender that is recorded. Comments Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value type Mappings rim: N/A
value[x]	I	1..1	BindingPattern	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.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). Binding RecordedGenderTypeValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://loinc.org", "code": "99502-7", "display": "Recorded sex or gender" } ] } Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
effectivePeriod	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod Short description When the recorded sex or gender value applies Definition The time period during which the recorded sex or gender value applies to the individual 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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 effectivePeriod Mappings rim: N/A
value[x]	I	0..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valuePeriod			Period	There are no (further) constraints on this element Data type Period
acquisitionDate	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate Short description When the sex or gender value was recorded. Definition The date/time when the sex or gender value was first recorded in the system. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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 acquisitionDate Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
sourceDocument	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument Short description The document the sex or gender property was acquired from. Definition The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded. Comments For example, if a driver's license is scanned, this property may reference that scanned document. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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 sourceDocument Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
valueReference			Reference(DocumentReference)	There are no (further) constraints on this element Data type Reference(DocumentReference)
sourceField	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField Short description The name of the field within the source document where this sex or gender property is initially recorded. Definition The name of the field within the source document where this sex or gender property is initially recorded. Comments For example, if a sex value is acquired from a driver's license, and the name of the field on that driver's license is 'SEX', then a code describing that field can be provided. If the semantics of the field are known, they may be described in the comment. For example, if the 'SEX' field on a license in a particular state or province is populated based on an individual's indication of what gender they consider themselves to be, but the field label is 'SEX' for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is 'SEX' can be provided. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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 sourceField Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
jurisdiction	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction Short description Who issued the document where the sex or gender was aquired Definition The jurisdiction or organization that issued the document from which the sex or gender was aquired Comments For example, a individual's driver's license or passport would be issued by a specific state or country. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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 jurisdiction Mappings rim: N/A
value[x]	I	1..1	Binding	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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). Binding http://terminology.hl7.org/ValueSet/jurisdiction (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
comment	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment Short description Context or source information about the recorded sex or gender Definition Further explanation about the context or source of the recorded sex or gender value 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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 comment Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
genderElementQualifier	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier Short description Whether this recorded sex or gender value qualifies the .gender element. Definition Instances of the individual-recordedSexOrGender extension with this value set to 'true' provides additional semantics or provenance of the data communicated in the relevant '.gender' property in the resource. For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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 genderElementQualifier Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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/StructureDefinition/individual-recordedSexOrGender Mappings rim: N/A
value[x]	I	0..0		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
genderIdentity	I	0..*	Extension(Complex)	There are no (further) constraints on this element Element id Patient.extension:genderIdentity Short description Extension for representing how the person prefers to self-describe. Alternate names extensions, user content Definition A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings. Comments This represents an individual’s identity, ascertained by asking them what that identity is. Data type Extension(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/individual-genderIdentity 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 pCHDCF-CACDI: Person Gender Identity
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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 id Mappings rim: n/a
extension	I	1..*	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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 managable, 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
value	I	1..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value Short description The individual's gender identity Definition An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else. Comments This represents an individual’s identity, ascertained by asking them what that identity is. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.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 value Mappings rim: N/A
value[x]	I	1..1	Binding	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.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). Binding GenderIdentityValueSet (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
period	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period Short description The time period during which the gender identity applies to the individual Definition The time period during which the gender identity applies to the individual 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value period Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valuePeriod			Period	There are no (further) constraints on this element Data type Period
comment	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment Short description Text to further explain the use of the specified gender identity Definition Text to further explain the use of the specified gender identity 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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 comment Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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/StructureDefinition/individual-genderIdentity Mappings rim: N/A
value[x]	I	0..0		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
pronouns	I	0..*	Extension(Complex)	There are no (further) constraints on this element Element id Patient.extension:pronouns Short description Third-person pronouns that may reference a person's gender identity (e.g. he, she, they) Alternate names extensions, user content Definition A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression. Comments This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release Data type Extension(Complex) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core 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 pCHDCF: Pronouns
birthsex	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension:birthsex Short description A code that specifies the sex of a person at birth which is a clinical finding Alternate names extensions, user content Definition A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Extension URL http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex 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
CommunicationBarrier	S I	0..*	Extension(base64Binary boolean canonical()code date dateTime decimal id instant integer markdown oid positiveInt string time unsignedInt uri url uuid Address Age Annotation Attachment CodeableConcept Coding ContactPoint Count Distance Duration HumanName Identifier Money Period Quantity Range Ratio Reference()SampledData Signature Timing ContactDetail Contributor DataRequirement Expression ParameterDefinition RelatedArtifact TriggerDefinition UsageContext Dosage Meta)	There are no (further) constraints on this element Element id Patient.extension:CommunicationBarrier Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(base64Binary boolean canonical()code date dateTime decimal id instant integer markdown oid positiveInt string time unsignedInt uri url uuid Address Age Annotation Attachment CodeableConcept Coding ContactPoint Count Distance Duration HumanName Identifier Money Period Quantity Range Ratio Reference()SampledData Signature Timing ContactDetail Contributor DataRequirement Expression ParameterDefinition RelatedArtifact TriggerDefinition UsageContext Dosage Meta) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier 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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May 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). 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. 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
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are generally assigned specific alphanumeric identifiers. Data type Identifier Sliced: Unordered, Open, by type(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id pCHDCF-CACDI: Patient Health Identifier pCHDCF-CACDI: Party Non-Health Identifier
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Jurisdictional Health Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN" } ] } Medical Record Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR" } ] } Passport Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "PPN" } ] } National Unique Identifier (Placeholder Concept) { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "NH" } ] } Mappings v2: CX.5 rim: Role.code or implied by context pCHDCF-CACDI: Patient Health Identifier Type Code pCHDCF-CACDI: Party Non-Health Identifier Type Code
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType pCHDCF-CACDI: Patient Health Identifier System pCHDCF-CACDI: *Issued By
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings 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 pCHDCF-CACDI: Patient Health Identifier pCHDCF-CACDI: Party Non-Health Identifier
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.period.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
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.identifier.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low pCHDCF-CACDI: Patient Health Identifier Effective Date
end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.identifier.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high pCHDCF-CACDI: Patient Health Identifier Expiry Date
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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 pCHDCF-CACDI: Issued By
JHN	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Patient.identifier:JHN Short description Jurisdictional Health Number Definition Patient and person health numbers used by all jurisdictions across Canada Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:JHN.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
versionCode	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.identifier:JHN.extension:versionCode Short description Health Number Version Code Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Extension URL http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion 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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:JHN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	There are no (further) constraints on this element Element id Patient.identifier:JHN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN", "display": "Jurisdictional Health Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.identifier:JHN.system Short description A Health Number Naming System from the Canadian URI Registry Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:JHN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:JHN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
MRN	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Patient.identifier:MRN Short description Medical Record Number Definition A local patient identifier from the submitting PoS System Requirements Patients are almost always assigned specific numerical identifiers. Comments Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:MRN.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:MRN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	There are no (further) constraints on this element Element id Patient.identifier:MRN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR", "display": "Medical Record Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.identifier:MRN.system Short description An identifier for the system supplying the MRN Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:MRN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:MRN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether 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. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	S Σ I	1..*	HumanName	There are no (further) constraints on this element Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided 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. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present. `(family.exists() or given.exists())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name pCHDCF-CACDI: Person Name
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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
use	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose pCHDCF-CACDI: Person Name Type Code
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element Requirements A renderable, unencoded form. Comments Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: implied by XPN.11 rim: ./formatted
family	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName pCHDCF-CACDI: Surname
given	S Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames pCHDCF-CACDI: Given Name pCHDCF-CACDI: Middle Name
prefix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN/4 rim: ./part[partType = SFX]
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.period.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
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.name.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low pCHDCF-CACDI: Person Name Effective Date
end	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.name.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high pCHDCF-CACDI: Person Name Expiry Date
telecom	S Σ	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom pCHDCF-CACDI: Contact Mechanism
id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.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
system	S Σ I	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.system Short description phone \| fax \| email \| pager \| url \| sms \| other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.3 rim: ./scheme servd: ./ContactPointType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.telecom.value Short description The actual contact point details Definition The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
use	S Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.use Short description home \| work \| temp \| old \| mobile - purpose of this contact point Definition Identifies the purpose for the contact point. 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. Data type code Binding Use of contact point. ContactPointUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose
rank	Σ	0..1	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies 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. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: n/a rim: n/a
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.period.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
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
gender	S Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.gender Short description The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation. Definition The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation. 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. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode pCHDCF-CACDI: Person Gender Used
birthDate	Σ	0..1	date	There are no (further) constraints on this element Element id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8 pCHDCF-CACDI: Person Birth Date
id		0..1	string	There are no (further) constraints on this element Element id Patient.birthDate.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.birthDate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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) 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()`
birthTime	I	0..1	Extension(dateTime)	There are no (further) constraints on this element Element id Patient.birthDate.extension:birthTime Short description Time of day of birth Alternate names extensions, user content Definition The time of day that the Patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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(dateTime) Extension URL http://hl7.org/fhir/StructureDefinition/patient-birthTime 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()`
value		0..1	System.Date	There are no (further) constraints on this element Element id Patient.birthDate.value Short description Primitive value for date Definition The actual value Data type System.Date
deceased[x]	S Σ ?!	0..1		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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 pCHDCF-CACDI: Person Death
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	S Σ	0..*	AddressCACore	There are no (further) constraints on this element Element id Patient.address Short description An address expressed using postal conventions (as opposed to GPS or other location definition formats) Definition An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Note: address is 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). Data type AddressCACore Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr rim: n/a v2: XAD rim: AD servd: Address
id		0..1	string	There are no (further) constraints on this element Element id Patient.address.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.use Short description home \| work \| temp \| old \| billing - purpose of this address Definition The purpose of this address. 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. Data type code Binding The use of an address. AddressUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General home Mappings v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.type Short description postal \| physical \| both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. 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). Data type code Binding The type of an address (physical / postal). AddressType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General both Mappings v2: XAD.18 rim: unique(./use) vcard: address type parameter
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies 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. 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. Data type string Constraints 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 v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
line	S Σ	0..*	string	There are no (further) constraints on this element Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street Mappings 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)
city	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Erewhon Mappings v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
district	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Madison Mappings v2: XAD.9 rim: AD.part[parttype = CNT \| CPA]
state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description The Province or Territory of Canada, or Province, Territory of State of another country Alternate names Province, Territory Definition The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
postalCode	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 9132 Mappings v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
country	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Recommend use of the HL7 Country ValueSet 3 letter code Definition Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo		0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-2 rim: name cda: n/a
telecom		0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. 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. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
organization	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period		0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: effectiveTime cda: n/a
communication		0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication pCHDCF-CACDI: Party Service Language
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The 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. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.language.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
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Patient.communication.language.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.language.coding.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
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.communication.language.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should 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: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	There are no (further) constraints on this element Element id Patient.communication.language.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Party Service Language Code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.language.coding.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 ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
preferred		0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner	S	0..*	Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/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. Data type Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
managingOrganization	Σ	0..1	Reference(OrganizationCACore)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
other	Σ	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso Definition The type of link between this patient resource and another patient resource. Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: typeCode cda: n/a

PatientCACore (Patient)	I		Patient	Element id Patient Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole pCHDCF-CACDI: Patient pCHDCF-CACDI: Person*
id	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These 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. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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) 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
indigenousIdentity	I	0..*	Extension(CodeableConcept)	Element id Patient.extension:indigenousIdentity Short description Extension for representing a code classifying a person's indigenous identity. Alternate names extensions, user content Definition A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type Extension(CodeableConcept) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core 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 pCHDCF-CACDI: Person Indigenous Identity
racializedGroup	I	0..*	Extension(CodeableConcept)	Element id Patient.extension:racializedGroup Short description Extension for representing a code classifying a person's racialized group. Alternate names extensions, user content Definition A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type Extension(CodeableConcept) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core 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 pCHDCF-CACDI: Person Racialized Group
recordedSexOrGender	I	0..*	Extension(Complex)	Element id Patient.extension:recordedSexOrGender Short description Recorded sex or gender (RSG) information includes the various sex and gender concepts. Alternate names extensions, user content Definition Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. 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(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender 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
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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 id Mappings rim: n/a
extension	I	1..*	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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 managable, 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
value	I	1..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value Short description The recorded sex or gender property for the individual Definition A sex or gender property for the individual from a document or other record 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:value.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 value Mappings rim: N/A
value[x]	I	1..1	Binding	Element id Patient.extension:recordedSexOrGender.extension:value.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). Binding RecordedGenderValueSet (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
type	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type Short description Type of recorded sex or gender. Definition The type or category of sex or gender that is recorded. Comments Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:type.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value type Mappings rim: N/A
value[x]	I	1..1	BindingPattern	Element id Patient.extension:recordedSexOrGender.extension:type.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). Binding RecordedGenderTypeValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://loinc.org", "code": "99502-7", "display": "Recorded sex or gender" } ] } Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
effectivePeriod	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod Short description When the recorded sex or gender value applies Definition The time period during which the recorded sex or gender value applies to the individual 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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 effectivePeriod Mappings rim: N/A
value[x]	I	0..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:effectivePeriod.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valuePeriod			Period	There are no (further) constraints on this element Data type Period
acquisitionDate	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate Short description When the sex or gender value was recorded. Definition The date/time when the sex or gender value was first recorded in the system. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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 acquisitionDate Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:acquisitionDate.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
sourceDocument	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument Short description The document the sex or gender property was acquired from. Definition The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded. Comments For example, if a driver's license is scanned, this property may reference that scanned document. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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 sourceDocument Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceDocument.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
valueReference			Reference(DocumentReference)	There are no (further) constraints on this element Data type Reference(DocumentReference)
sourceField	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField Short description The name of the field within the source document where this sex or gender property is initially recorded. Definition The name of the field within the source document where this sex or gender property is initially recorded. Comments For example, if a sex value is acquired from a driver's license, and the name of the field on that driver's license is 'SEX', then a code describing that field can be provided. If the semantics of the field are known, they may be described in the comment. For example, if the 'SEX' field on a license in a particular state or province is populated based on an individual's indication of what gender they consider themselves to be, but the field label is 'SEX' for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is 'SEX' can be provided. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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 sourceField Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:sourceField.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
jurisdiction	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction Short description Who issued the document where the sex or gender was aquired Definition The jurisdiction or organization that issued the document from which the sex or gender was aquired Comments For example, a individual's driver's license or passport would be issued by a specific state or country. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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 jurisdiction Mappings rim: N/A
value[x]	I	1..1	Binding	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:jurisdiction.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). Binding http://terminology.hl7.org/ValueSet/jurisdiction (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
comment	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment Short description Context or source information about the recorded sex or gender Definition Further explanation about the context or source of the recorded sex or gender value 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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 comment Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:comment.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
genderElementQualifier	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier Short description Whether this recorded sex or gender value qualifies the .gender element. Definition Instances of the individual-recordedSexOrGender extension with this value set to 'true' provides additional semantics or provenance of the data communicated in the relevant '.gender' property in the resource. For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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 genderElementQualifier Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.extension:genderElementQualifier.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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/StructureDefinition/individual-recordedSexOrGender Mappings rim: N/A
value[x]	I	0..0		There are no (further) constraints on this element Element id Patient.extension:recordedSexOrGender.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
genderIdentity	I	0..*	Extension(Complex)	Element id Patient.extension:genderIdentity Short description Extension for representing how the person prefers to self-describe. Alternate names extensions, user content Definition A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings. Comments This represents an individual’s identity, ascertained by asking them what that identity is. Data type Extension(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/individual-genderIdentity 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 pCHDCF-CACDI: Person Gender Identity
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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 id Mappings rim: n/a
extension	I	1..*	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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 managable, 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
value	I	1..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value Short description The individual's gender identity Definition An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else. Comments This represents an individual’s identity, ascertained by asking them what that identity is. 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:value.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 value Mappings rim: N/A
value[x]	I	1..1	Binding	Element id Patient.extension:genderIdentity.extension:value.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). Binding GenderIdentityValueSet (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
period	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period Short description The time period during which the gender identity applies to the individual Definition The time period during which the gender identity applies to the individual 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value period Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:period.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valuePeriod			Period	There are no (further) constraints on this element Data type Period
comment	I	0..1	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment Short description Text to further explain the use of the specified gender identity Definition Text to further explain the use of the specified gender identity 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()`
id		0..1	id	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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 id Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.extension Short description Extension Definition An Extension 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()`
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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 comment Mappings rim: N/A
value[x]	I	1..1		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.extension:comment.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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/StructureDefinition/individual-genderIdentity Mappings rim: N/A
value[x]	I	0..0		There are no (further) constraints on this element Element id Patient.extension:genderIdentity.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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
pronouns	I	0..*	Extension(Complex)	Element id Patient.extension:pronouns Short description Third-person pronouns that may reference a person's gender identity (e.g. he, she, they) Alternate names extensions, user content Definition A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression. Comments This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release Data type Extension(Complex) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core 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 pCHDCF: Pronouns
birthsex	I	0..1	Extension	Element id Patient.extension:birthsex Short description A code that specifies the sex of a person at birth which is a clinical finding Alternate names extensions, user content Definition A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics. 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 Extension URL http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex 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
CommunicationBarrier	S I	0..*	Extension(base64Binary boolean canonical()code date dateTime decimal id instant integer markdown oid positiveInt string time unsignedInt uri url uuid Address Age Annotation Attachment CodeableConcept Coding ContactPoint Count Distance Duration HumanName Identifier Money Period Quantity Range Ratio Reference()SampledData Signature Timing ContactDetail Contributor DataRequirement Expression ParameterDefinition RelatedArtifact TriggerDefinition UsageContext Dosage Meta)	Element id Patient.extension:CommunicationBarrier Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(base64Binary boolean canonical()code date dateTime decimal id instant integer markdown oid positiveInt string time unsignedInt uri url uuid Address Age Annotation Attachment CodeableConcept Coding ContactPoint Count Distance Duration HumanName Identifier Money Period Quantity Range Ratio Reference()SampledData Signature Timing ContactDetail Contributor DataRequirement Expression ParameterDefinition RelatedArtifact TriggerDefinition UsageContext Dosage Meta) Extension URL http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier 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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May 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). 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. 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
identifier	S Σ	0..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are generally assigned specific alphanumeric identifiers. Data type Identifier Sliced: Unordered, Open, by type(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id pCHDCF-CACDI: Patient Health Identifier pCHDCF-CACDI: Party Non-Health Identifier
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	1..1	CodeableConceptBinding	Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Jurisdictional Health Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN" } ] } Medical Record Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR" } ] } Passport Number { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "PPN" } ] } National Unique Identifier (Placeholder Concept) { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "NH" } ] } Mappings v2: CX.5 rim: Role.code or implied by context pCHDCF-CACDI: Patient Health Identifier Type Code pCHDCF-CACDI: Party Non-Health Identifier Type Code
system	S Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType pCHDCF-CACDI: Patient Health Identifier System pCHDCF-CACDI: *Issued By
value	S Σ	1..1	string	Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings 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 pCHDCF-CACDI: Patient Health Identifier pCHDCF-CACDI: Party Non-Health Identifier
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.period.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
start	Σ I	0..1	dateTime	Element id Patient.identifier.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low pCHDCF-CACDI: Patient Health Identifier Effective Date
end	Σ I	0..1	dateTime	Element id Patient.identifier.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high pCHDCF-CACDI: Patient Health Identifier Expiry Date
assigner	Σ	0..1	Reference(Organization)	Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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 pCHDCF-CACDI: Issued By
JHN	Σ	0..*	Identifier	Element id Patient.identifier:JHN Short description Jurisdictional Health Number Definition Patient and person health numbers used by all jurisdictions across Canada Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:JHN.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
versionCode	I	0..1	Extension	Element id Patient.identifier:JHN.extension:versionCode Short description Health Number Version Code Alternate names extensions, user content Definition A code indicating a specific version of an identifier credential Comments For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential Data type Extension Extension URL http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion 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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:JHN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	Element id Patient.identifier:JHN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN", "display": "Jurisdictional Health Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	Element id Patient.identifier:JHN.system Short description A Health Number Naming System from the Canadian URI Registry Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:JHN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:JHN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
MRN	Σ	0..*	Identifier	Element id Patient.identifier:MRN Short description Medical Record Number Definition A local patient identifier from the submitting PoS System Requirements Patients are almost always assigned specific numerical identifiers. Comments Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:MRN.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:MRN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	Element id Patient.identifier:MRN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR", "display": "Medical Record Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	Element id Patient.identifier:MRN.system Short description An identifier for the system supplying the MRN Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:MRN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:MRN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
active	Σ ?!	0..1	boolean	Element id Patient.active Short description Whether this patient's record is in active use Definition Whether 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. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	S Σ I	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided 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. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present. `(family.exists() or given.exists())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name pCHDCF-CACDI: Person Name
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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
use	Σ ?!	1..1	codeBinding	Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose pCHDCF-CACDI: Person Name Type Code
text	Σ	0..1	string	Element id Patient.name.text Short description Text representation of the full name Definition Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element Requirements A renderable, unencoded form. Comments Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: implied by XPN.11 rim: ./formatted
family	S Σ	0..1	string	Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName pCHDCF-CACDI: Surname
given	S Σ	0..*	string	Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames pCHDCF-CACDI: Given Name pCHDCF-CACDI: Middle Name
prefix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN/4 rim: ./part[partType = SFX]
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.period.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
start	Σ I	0..1	dateTime	Element id Patient.name.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low pCHDCF-CACDI: Person Name Effective Date
end	S Σ I	0..1	dateTime	Element id Patient.name.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR). Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high pCHDCF-CACDI: Person Name Expiry Date
telecom	S Σ	0..*	ContactPoint	Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. 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). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom pCHDCF-CACDI: Contact Mechanism
id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.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
system	S Σ I	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.system Short description phone \| fax \| email \| pager \| url \| sms \| other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.3 rim: ./scheme servd: ./ContactPointType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.telecom.value Short description The actual contact point details Definition The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
use	S Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.use Short description home \| work \| temp \| old \| mobile - purpose of this contact point Definition Identifies the purpose for the contact point. 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. Data type code Binding Use of contact point. ContactPointUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose
rank	Σ	0..1	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies 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. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: n/a rim: n/a
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.period.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.period.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
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
gender	S Σ	0..1	codeBinding	Element id Patient.gender Short description The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation. Definition The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation. 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. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode pCHDCF-CACDI: Person Gender Used
birthDate	Σ	0..1	date	Element id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8 pCHDCF-CACDI: Person Birth Date
id		0..1	string	There are no (further) constraints on this element Element id Patient.birthDate.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	Element id Patient.birthDate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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) 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()`
birthTime	I	0..1	Extension(dateTime)	Element id Patient.birthDate.extension:birthTime Short description Time of day of birth Alternate names extensions, user content Definition The time of day that the Patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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(dateTime) Extension URL http://hl7.org/fhir/StructureDefinition/patient-birthTime 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()`
value		0..1	System.Date	There are no (further) constraints on this element Element id Patient.birthDate.value Short description Primitive value for date Definition The actual value Data type System.Date
deceased[x]	S Σ ?!	0..1		Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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 pCHDCF-CACDI: Person Death
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	S Σ	0..*	AddressCACore	Element id Patient.address Short description An address expressed using postal conventions (as opposed to GPS or other location definition formats) Definition An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Note: address is 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). Data type AddressCACore Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr rim: n/a v2: XAD rim: AD servd: Address
id		0..1	string	There are no (further) constraints on this element Element id Patient.address.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.use Short description home \| work \| temp \| old \| billing - purpose of this address Definition The purpose of this address. 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. Data type code Binding The use of an address. AddressUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General home Mappings v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.type Short description postal \| physical \| both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. 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). Data type code Binding The type of an address (physical / postal). AddressType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General both Mappings v2: XAD.18 rim: unique(./use) vcard: address type parameter
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies 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. 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. Data type string Constraints 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 v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
line	S Σ	0..*	string	There are no (further) constraints on this element Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street Mappings 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)
city	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Erewhon Mappings v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
district	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Madison Mappings v2: XAD.9 rim: AD.part[parttype = CNT \| CPA]
state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description The Province or Territory of Canada, or Province, Territory of State of another country Alternate names Province, Territory Definition The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
postalCode	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 9132 Mappings v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
country	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Recommend use of the HL7 Country ValueSet 3 letter code Definition Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings 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
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo		0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() 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: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-7, NK1-3 rim: code cda: n/a
name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-2 rim: name cda: n/a
telecom		0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. 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. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
organization	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period		0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: effectiveTime cda: n/a
communication		0..*	BackboneElement	Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication pCHDCF-CACDI: Party Service Language
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The 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. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.language.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
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Patient.communication.language.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.language.coding.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
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.communication.language.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should 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: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	Element id Patient.communication.language.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Party Service Language Code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.language.coding.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 ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.language.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
preferred		0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner	S	0..*	Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore)	Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/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. Data type Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
managingOrganization	Σ	0..1	Reference(OrganizationCACore)	Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.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
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. 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
other	Σ	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso Definition The type of link between this patient resource and another patient resource. Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: typeCode cda: n/a

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="patient-ca-core" />
    <url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
    <name value="PatientCACore" />
    <title value="Patient (CA-Core)" />
    <status value="draft" />
    <experimental value="false" />
    <date value="2025-03-17" />
    <publisher value="Canada Health Infoway" />
    <contact>
        <name value="National Standards Release Centre" />
        <telecom>
            <system value="url" />
            <value value="http://www.infoway-inforoute.ca" />
        </telecom>
        <telecom>
            <system value="email" />
            <value value="standards@infoway-inforoute.ca" />
        </telecom>
    </contact>
    <description value="This profile applies constraints to the Patient resource for CA Core+ to support identity, demographics, and administrative data in the pan-Canadian context." />
    <jurisdiction>
        <coding>
            <system value="urn:iso:std:iso:3166" />
            <code value="CA" />
        </coding>
    </jurisdiction>
    <copyright value="Copyright &#169; 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="pCHDCF-CACDI" />
        <name value="Pan-Canadian Health Data Content Framework - CACDI" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Patient" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
    <derivation value="constraint" />
    <snapshot>
        <element id="Patient">
            <path value="Patient" />
            <short value="Information about an individual or animal receiving health care services" />
            <definition value="Demographics and other administrative information about an individual or animal receiving care or other health-related services." />
            <alias value="SubjectOfCare Client Resident" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient" />
                <min value="0" />
                <max value="*" />
            </base>
            <constraint>
                <key value="dom-2" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
                <expression value="contained.contained.empty()" />
                <xpath value="not(parent::f:contained and f:contained)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-3" />
                <severity value="error" />
                <human value="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" />
                <expression value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-4" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
                <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-5" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
                <expression value="contained.meta.security.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
                    <valueBoolean value="true" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
                    <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
                </extension>
                <key value="dom-6" />
                <severity value="warning" />
                <human value="A resource should have narrative for robust management" />
                <expression value="text.`div`.exists()" />
                <xpath value="exists(f:text/h:div)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Patient[classCode=PAT]" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument.recordTarget.patientRole" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person*" />
                <comment value="*In the context of a person in a Party Role of Patient" />
            </mapping>
        </element>
        <element id="Patient.id">
            <path value="Patient.id" />
            <short value="Logical id of this artifact" />
            <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
            <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="Patient.meta">
            <path value="Patient.meta" />
            <short value="Metadata about the resource" />
            <definition value="The 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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.meta" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Meta" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="Patient.implicitRules">
            <path value="Patient.implicitRules" />
            <short value="A set of rules under which this content was created" />
            <definition value="A 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." />
            <comment value="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&#39;s narrative along with other profiles, value sets, etc." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.implicitRules" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation" />
            <isSummary value="true" />
        </element>
        <element id="Patient.language">
            <path value="Patient.language" />
            <short value="Language of the resource content" />
            <definition value="The base language in which the resource is written." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.language" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
        </element>
        <element id="Patient.text">
            <path value="Patient.text" />
            <short value="Text summary of the resource, for human interpretation" />
            <definition value="A 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
            <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
            <alias value="narrative" />
            <alias value="html" />
            <alias value="xhtml" />
            <alias value="display" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Narrative" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="Patient.contained">
            <path value="Patient.contained" />
            <short value="Contained, inline Resources" />
            <definition value="These 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." />
            <comment value="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." />
            <alias value="inline resources" />
            <alias value="anonymous resources" />
            <alias value="contained resources" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.contained" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Resource" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension">
            <path value="Patient.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="May 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:indigenousIdentity">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.extension" />
            <sliceName value="indigenousIdentity" />
            <short value="Extension for representing a code classifying a person&#39;s indigenous identity." />
            <definition value="A code classifying a person&#39;s self-identification as either First Nations, Inuk/Inuit and/or M&#233;tis." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Indigenous Identity" />
            </mapping>
        </element>
        <element id="Patient.extension:racializedGroup">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.extension" />
            <sliceName value="racializedGroup" />
            <short value="Extension for representing a code classifying a person&#39;s racialized group." />
            <definition value="A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Racialized Group" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender">
            <path value="Patient.extension" />
            <sliceName value="recordedSexOrGender" />
            <short value="Recorded sex or gender (RSG) information includes the various sex and gender concepts." />
            <definition value="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.id">
            <path value="Patient.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension">
            <path value="Patient.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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 managable, 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value">
            <path value="Patient.extension.extension" />
            <sliceName value="value" />
            <short value="The recorded sex or gender property for the individual" />
            <definition value="A sex or gender property for the individual from a document or other record" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="value" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="recordedSexOrGender" />
                </extension>
                <strength value="extensible" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/recordedgender" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type">
            <path value="Patient.extension.extension" />
            <sliceName value="type" />
            <short value="Type of recorded sex or gender." />
            <definition value="The type or category of sex or gender that is recorded." />
            <comment value="Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="type" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <patternCodeableConcept>
                <coding>
                    <system value="http://loinc.org" />
                    <code value="99502-7" />
                    <display value="Recorded sex or gender" />
                </coding>
            </patternCodeableConcept>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="recordedSexOrGenderType" />
                </extension>
                <strength value="required" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:effectivePeriod">
            <path value="Patient.extension.extension" />
            <sliceName value="effectivePeriod" />
            <short value="When the recorded sex or gender value applies" />
            <definition value="The time period during which the recorded sex or gender value applies to the individual" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:effectivePeriod.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:effectivePeriod.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="effectivePeriod" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:effectivePeriod.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:acquisitionDate">
            <path value="Patient.extension.extension" />
            <sliceName value="acquisitionDate" />
            <short value="When the sex or gender value was recorded." />
            <definition value="The date/time when the sex or gender value was first recorded in the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:acquisitionDate.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:acquisitionDate.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="acquisitionDate" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:acquisitionDate.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceDocument">
            <path value="Patient.extension.extension" />
            <sliceName value="sourceDocument" />
            <short value="The document the sex or gender property was acquired from." />
            <definition value="The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded." />
            <comment value="For example, if a driver&#39;s license is scanned, this property may reference that scanned document." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceDocument.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceDocument.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceDocument.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="sourceDocument" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceDocument.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceField">
            <path value="Patient.extension.extension" />
            <sliceName value="sourceField" />
            <short value="The name of the field within the source document where this sex or gender property is initially recorded." />
            <definition value="The name of the field within the source document where this sex or gender property is initially recorded." />
            <comment value="For example, if a sex value is acquired from a driver&#39;s license, and the name of the field on that driver&#39;s license is &#39;SEX&#39;, then a code describing that field can be provided.  If the semantics of the field are known, they may be described in the comment.  For example, if the &#39;SEX&#39; field on a license in a particular state or province is populated based on an individual&#39;s indication of what gender they consider themselves to be, but the field label is &#39;SEX&#39; for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is &#39;SEX&#39; can be provided." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceField.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceField.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceField.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="sourceField" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:sourceField.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:jurisdiction">
            <path value="Patient.extension.extension" />
            <sliceName value="jurisdiction" />
            <short value="Who issued the document where the sex or gender was aquired" />
            <definition value="The jurisdiction or organization that issued the document from which the sex or gender was aquired" />
            <comment value="For example, a individual&#39;s driver&#39;s license or passport would be issued by a specific state or country." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:jurisdiction.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:jurisdiction.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:jurisdiction.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="jurisdiction" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:jurisdiction.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Jurisdiction ValueSet" />
                </extension>
                <strength value="extensible" />
                <valueSet value="http://terminology.hl7.org/ValueSet/jurisdiction" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:comment">
            <path value="Patient.extension.extension" />
            <sliceName value="comment" />
            <short value="Context or source information about the recorded sex or gender" />
            <definition value="Further explanation about the context or source of the recorded sex or gender value" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:comment.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:comment.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:comment.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="comment" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:comment.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:genderElementQualifier">
            <path value="Patient.extension.extension" />
            <sliceName value="genderElementQualifier" />
            <short value="Whether this recorded sex or gender value qualifies the .gender element." />
            <definition value="Instances of the individual-recordedSexOrGender extension with this value set to &#39;true&#39; provides additional semantics or provenance of the data communicated in the relevant &#39;.gender&#39; property in the resource.  For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:genderElementQualifier.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:genderElementQualifier.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="genderElementQualifier" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:genderElementQualifier.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.url">
            <path value="Patient.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="uri" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <fixedUri value="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender.value[x]">
            <path value="Patient.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="base64Binary" />
            </type>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="canonical" />
            </type>
            <type>
                <code value="code" />
            </type>
            <type>
                <code value="date" />
            </type>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="decimal" />
            </type>
            <type>
                <code value="id" />
            </type>
            <type>
                <code value="instant" />
            </type>
            <type>
                <code value="integer" />
            </type>
            <type>
                <code value="integer64" />
            </type>
            <type>
                <code value="markdown" />
            </type>
            <type>
                <code value="oid" />
            </type>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="time" />
            </type>
            <type>
                <code value="unsignedInt" />
            </type>
            <type>
                <code value="uri" />
            </type>
            <type>
                <code value="url" />
            </type>
            <type>
                <code value="uuid" />
            </type>
            <type>
                <code value="Address" />
            </type>
            <type>
                <code value="Age" />
            </type>
            <type>
                <code value="Annotation" />
            </type>
            <type>
                <code value="Attachment" />
            </type>
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="CodeableReference" />
            </type>
            <type>
                <code value="Coding" />
            </type>
            <type>
                <code value="ContactPoint" />
            </type>
            <type>
                <code value="Count" />
            </type>
            <type>
                <code value="Distance" />
            </type>
            <type>
                <code value="Duration" />
            </type>
            <type>
                <code value="HumanName" />
            </type>
            <type>
                <code value="Identifier" />
            </type>
            <type>
                <code value="Money" />
            </type>
            <type>
                <code value="Period" />
            </type>
            <type>
                <code value="Quantity" />
            </type>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="Ratio" />
            </type>
            <type>
                <code value="RatioRange" />
            </type>
            <type>
                <code value="Reference" />
            </type>
            <type>
                <code value="SampledData" />
            </type>
            <type>
                <code value="Signature" />
            </type>
            <type>
                <code value="Timing" />
            </type>
            <type>
                <code value="ContactDetail" />
            </type>
            <type>
                <code value="DataRequirement" />
            </type>
            <type>
                <code value="Expression" />
            </type>
            <type>
                <code value="ParameterDefinition" />
            </type>
            <type>
                <code value="RelatedArtifact" />
            </type>
            <type>
                <code value="TriggerDefinition" />
            </type>
            <type>
                <code value="UsageContext" />
            </type>
            <type>
                <code value="Availability" />
            </type>
            <type>
                <code value="ExtendedContactDetail" />
            </type>
            <type>
                <code value="Dosage" />
            </type>
            <type>
                <code value="Meta" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity">
            <path value="Patient.extension" />
            <sliceName value="genderIdentity" />
            <short value="Extension for representing how the person prefers to self-describe." />
            <definition value="A code that specifies an individual&#39;s personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings." />
            <comment value="This represents an individual’s identity, ascertained by asking them what that identity is." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/individual-genderIdentity" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Gender Identity" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.id">
            <path value="Patient.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension">
            <path value="Patient.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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 managable, 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:value">
            <path value="Patient.extension.extension" />
            <sliceName value="value" />
            <short value="The individual&#39;s gender identity" />
            <definition value="An individual&#39;s personal sense of being a man, woman, boy, girl, nonbinary, or something else." />
            <comment value="This represents an individual’s identity, ascertained by asking them what that identity is." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:value.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:value.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:value.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="value" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:value.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="GenderIdentity" />
                </extension>
                <strength value="extensible" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:period">
            <path value="Patient.extension.extension" />
            <sliceName value="period" />
            <short value="The time period during which the gender identity applies to the individual" />
            <definition value="The time period during which the gender identity applies to the individual" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:period.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:period.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:period.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="period" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:period.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:comment">
            <path value="Patient.extension.extension" />
            <sliceName value="comment" />
            <short value="Text to further explain the use of the specified gender identity" />
            <definition value="Text to further explain the use of the specified gender identity" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:comment.id">
            <path value="Patient.extension.extension.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="id" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <condition value="ele-1" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:comment.extension">
            <path value="Patient.extension.extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extension" />
            <definition value="An Extension" />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:comment.url">
            <path value="Patient.extension.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="comment" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:comment.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.url">
            <path value="Patient.extension.url" />
            <representation value="xmlAttr" />
            <short value="identifies the meaning of the extension" />
            <definition value="Source of the definition for the extension code - a logical name or a URL." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Extension.url" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="uri" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <fixedUri value="http://hl7.org/fhir/StructureDefinition/individual-genderIdentity" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.value[x]">
            <path value="Patient.extension.value[x]" />
            <short value="Value of extension" />
            <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Extension.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="base64Binary" />
            </type>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="canonical" />
            </type>
            <type>
                <code value="code" />
            </type>
            <type>
                <code value="date" />
            </type>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="decimal" />
            </type>
            <type>
                <code value="id" />
            </type>
            <type>
                <code value="instant" />
            </type>
            <type>
                <code value="integer" />
            </type>
            <type>
                <code value="integer64" />
            </type>
            <type>
                <code value="markdown" />
            </type>
            <type>
                <code value="oid" />
            </type>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="time" />
            </type>
            <type>
                <code value="unsignedInt" />
            </type>
            <type>
                <code value="uri" />
            </type>
            <type>
                <code value="url" />
            </type>
            <type>
                <code value="uuid" />
            </type>
            <type>
                <code value="Address" />
            </type>
            <type>
                <code value="Age" />
            </type>
            <type>
                <code value="Annotation" />
            </type>
            <type>
                <code value="Attachment" />
            </type>
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="CodeableReference" />
            </type>
            <type>
                <code value="Coding" />
            </type>
            <type>
                <code value="ContactPoint" />
            </type>
            <type>
                <code value="Count" />
            </type>
            <type>
                <code value="Distance" />
            </type>
            <type>
                <code value="Duration" />
            </type>
            <type>
                <code value="HumanName" />
            </type>
            <type>
                <code value="Identifier" />
            </type>
            <type>
                <code value="Money" />
            </type>
            <type>
                <code value="Period" />
            </type>
            <type>
                <code value="Quantity" />
            </type>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="Ratio" />
            </type>
            <type>
                <code value="RatioRange" />
            </type>
            <type>
                <code value="Reference" />
            </type>
            <type>
                <code value="SampledData" />
            </type>
            <type>
                <code value="Signature" />
            </type>
            <type>
                <code value="Timing" />
            </type>
            <type>
                <code value="ContactDetail" />
            </type>
            <type>
                <code value="DataRequirement" />
            </type>
            <type>
                <code value="Expression" />
            </type>
            <type>
                <code value="ParameterDefinition" />
            </type>
            <type>
                <code value="RelatedArtifact" />
            </type>
            <type>
                <code value="TriggerDefinition" />
            </type>
            <type>
                <code value="UsageContext" />
            </type>
            <type>
                <code value="Availability" />
            </type>
            <type>
                <code value="ExtendedContactDetail" />
            </type>
            <type>
                <code value="Dosage" />
            </type>
            <type>
                <code value="Meta" />
            </type>
            <condition value="ext-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.extension:pronouns">
            <path value="Patient.extension" />
            <sliceName value="pronouns" />
            <short value="Third-person pronouns that may reference a person&#39;s gender identity (e.g. he, she, they)" />
            <definition value="A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person&#39;s gender identity (e.g. he, she, they) and that may be a part of their gender expression." />
            <comment value="This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept &#39;Pronouns&#39;. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release" />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF" />
                <map value="Pronouns" />
            </mapping>
        </element>
        <element id="Patient.extension:birthsex">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.extension" />
            <sliceName value="birthsex" />
            <short value="A code that specifies the sex of a person at birth which is a clinical finding" />
            <definition value="A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.extension:CommunicationBarrier">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.extension" />
            <sliceName value="CommunicationBarrier" />
            <short value="Optional Extensions Element" />
            <definition value="Optional Extension Element - found in all resources." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.modifierExtension">
            <path value="Patient.modifierExtension" />
            <short value="Extensions that cannot be ignored" />
            <definition value="May 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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="type" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="An identifier for this patient" />
            <definition value="An identifier for this patient." />
            <requirements value="Patients are generally assigned specific alphanumeric identifiers." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PID-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".id" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier" />
            </mapping>
        </element>
        <element id="Patient.identifier.id">
            <path value="Patient.identifier.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier.extension">
            <path value="Patient.identifier.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier.use">
            <path value="Patient.identifier.use" />
            <short value="usual | official | temp | secondary | old (If known)" />
            <definition value="The purpose of this identifier." />
            <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
            <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierUse" />
                </extension>
                <strength value="required" />
                <description value="Identifies the purpose for this identifier, if known ." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="Patient.identifier.type">
            <path value="Patient.identifier.type" />
            <short value="Description of identifier" />
            <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
            <comment value="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." />
            <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Identifier.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <example>
                <label value="Jurisdictional Health Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="JHN" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="Medical Record Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="MR" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="Passport Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="PPN" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="National Unique Identifier (Placeholder Concept)" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="NH" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierType" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="CX.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Type Code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier Type Code" />
            </mapping>
        </element>
        <element id="Patient.identifier.system">
            <path value="Patient.identifier.system" />
            <short value="The namespace for the identifier value" />
            <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
            <comment value="Identifier.system is always case sensitive." />
            <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Identifier.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <example>
                <label value="General" />
                <valueUri value="http://www.acme.com/identifiers/patient" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / EI-2-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.root or Role.id.root" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierType" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier System" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="*Issued By" />
                <comment value="*Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner" />
            </mapping>
        </element>
        <element id="Patient.identifier.value">
            <path value="Patient.identifier.value" />
            <short value="The value that is unique" />
            <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
            <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;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](extension-rendered-value.html). 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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Identifier.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="123456" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.1 / EI.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Value" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier" />
            </mapping>
        </element>
        <element id="Patient.identifier.period">
            <path value="Patient.identifier.period" />
            <short value="Time period when id is/was valid for use" />
            <definition value="Time period during which identifier is/was valid for use." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.7 + CX.8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.effectiveTime or implied by context" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.id">
            <path value="Patient.identifier.period.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.extension">
            <path value="Patient.identifier.period.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.start">
            <path value="Patient.identifier.period.start" />
            <short value="Starting time with inclusive boundary" />
            <definition value="The start of the period. The boundary is inclusive." />
            <comment value="This attribute is considered &#39;Recommended - No Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.start" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./low" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Effective Date" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.end">
            <path value="Patient.identifier.period.end" />
            <short value="End time with inclusive boundary, if not ongoing" />
            <definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
            <comment value="This attribute is considered &#39;Recommended - Allow Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.end" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./high" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Expiry Date" />
            </mapping>
        </element>
        <element id="Patient.identifier.assigner">
            <path value="Patient.identifier.assigner" />
            <short value="Organization that issued id (may be just text)" />
            <definition value="Organization that issued/manages the identifier." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.assigner" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / (CX.4,CX.9,CX.10)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierIssuingAuthority" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Issued By" />
                <comment value="Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN">
            <path value="Patient.identifier" />
            <sliceName value="JHN" />
            <short value="Jurisdictional Health Number" />
            <definition value="Patient and person health numbers used by all jurisdictions across Canada" />
            <requirements value="Patients are almost always assigned specific numerical identifiers." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PID-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".id" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.id">
            <path value="Patient.identifier.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.extension">
            <path value="Patient.identifier.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.extension:versionCode">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.identifier.extension" />
            <sliceName value="versionCode" />
            <short value="Health Number Version Code" />
            <definition value="Optional Extension Element - found in all resources." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.use">
            <path value="Patient.identifier.use" />
            <short value="usual | official | temp | secondary | old (If known)" />
            <definition value="The purpose of this identifier." />
            <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
            <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierUse" />
                </extension>
                <strength value="required" />
                <description value="Identifies the purpose for this identifier, if known ." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.type">
            <path value="Patient.identifier.type" />
            <short value="Description of identifier" />
            <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
            <comment value="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." />
            <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="JHN" />
                    <display value="Jurisdictional Health Number" />
                </coding>
            </patternCodeableConcept>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierType" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="CX.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.system">
            <path value="Patient.identifier.system" />
            <short value="A Health Number Naming System from the Canadian URI Registry" />
            <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
            <comment value="Identifier.system is always case sensitive." />
            <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <example>
                <label value="General" />
                <valueUri value="http://www.acme.com/identifiers/patient" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / EI-2-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.root or Role.id.root" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierType" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.value">
            <path value="Patient.identifier.value" />
            <short value="The value that is unique" />
            <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
            <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;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](extension-rendered-value.html). 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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="123456" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.1 / EI.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Value" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.period">
            <path value="Patient.identifier.period" />
            <short value="Time period when id is/was valid for use" />
            <definition value="Time period during which identifier is/was valid for use." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.7 + CX.8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.effectiveTime or implied by context" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN.assigner">
            <path value="Patient.identifier.assigner" />
            <short value="Organization that issued id (may be just text)" />
            <definition value="Organization that issued/manages the identifier." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.assigner" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / (CX.4,CX.9,CX.10)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierIssuingAuthority" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN">
            <path value="Patient.identifier" />
            <sliceName value="MRN" />
            <short value="Medical Record Number" />
            <definition value="A local patient identifier from the submitting PoS System" />
            <comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
            <requirements value="Patients are almost always assigned specific numerical identifiers." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PID-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".id" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.id">
            <path value="Patient.identifier.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.extension">
            <path value="Patient.identifier.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.use">
            <path value="Patient.identifier.use" />
            <short value="usual | official | temp | secondary | old (If known)" />
            <definition value="The purpose of this identifier." />
            <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
            <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierUse" />
                </extension>
                <strength value="required" />
                <description value="Identifies the purpose for this identifier, if known ." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.type">
            <path value="Patient.identifier.type" />
            <short value="Description of identifier" />
            <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
            <comment value="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." />
            <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="MR" />
                    <display value="Medical Record Number" />
                </coding>
            </patternCodeableConcept>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierType" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
                <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="CX.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.system">
            <path value="Patient.identifier.system" />
            <short value="An identifier for the system supplying the MRN" />
            <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
            <comment value="Identifier.system is always case sensitive." />
            <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <example>
                <label value="General" />
                <valueUri value="http://www.acme.com/identifiers/patient" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / EI-2-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.root or Role.id.root" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierType" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.value">
            <path value="Patient.identifier.value" />
            <short value="The value that is unique" />
            <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
            <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;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](extension-rendered-value.html). 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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="123456" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.1 / EI.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Value" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.period">
            <path value="Patient.identifier.period" />
            <short value="Time period when id is/was valid for use" />
            <definition value="Time period during which identifier is/was valid for use." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.7 + CX.8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.effectiveTime or implied by context" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.identifier:MRN.assigner">
            <path value="Patient.identifier.assigner" />
            <short value="Organization that issued id (may be just text)" />
            <definition value="Organization that issued/manages the identifier." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.assigner" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / (CX.4,CX.9,CX.10)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierIssuingAuthority" />
            </mapping>
        </element>
        <element id="Patient.active">
            <path value="Patient.active" />
            <short value="Whether this patient&#39;s record is in active use" />
            <definition value="Whether this patient record is in active use. \nMany 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&#39;s business rules.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death." />
            <comment value="it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients" />
            <requirements value="Need to be able to mark a patient record as not to be used because it was created in error." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.active" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.status" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="statusCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <short value="A name associated with the patient" />
            <definition value="A name associated with the individual." />
            <comment value="A patient may have multiple names with different uses or applicable periods. For animals, the name is a &quot;HumanName&quot; in the sense that is assigned and used by humans and has the same patterns." />
            <requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided" />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="Patient.name" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="HumanName" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ca-core-pat-1" />
                <severity value="error" />
                <human value="Either Patient.name.given and/or Patient.name.family SHALL be present." />
                <expression value="(family.exists() or given.exists())" />
                <xpath value="(/f:name/f:family or /f:name/f:given)" />
                <source value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-5, PID-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="name" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".patient.name" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name" />
            </mapping>
        </element>
        <element id="Patient.name.id">
            <path value="Patient.name.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.name.extension">
            <path value="Patient.name.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.name.use">
            <path value="Patient.name.use" />
            <short value="usual | official | temp | nickname | anonymous | old | maiden" />
            <definition value="Identifies the purpose for this name." />
            <comment value="Applications can assume that a name is current unless it explicitly says that it is temporary or old." />
            <requirements value="Allows the appropriate name for a particular context of use to be selected from among a set of names." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="HumanName.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old name etc.for a current/permanent one" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="NameUse" />
                </extension>
                <strength value="required" />
                <description value="The use of a human name." />
                <valueSet value="http://hl7.org/fhir/ValueSet/name-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="XPN.7, but often indicated by which field contains the name" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="unique(./use)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./NamePurpose" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Type Code" />
            </mapping>
        </element>
        <element id="Patient.name.text">
            <path value="Patient.name.text" />
            <short value="Text representation of the full name" />
            <definition value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element" />
            <comment value="Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance" />
            <requirements value="A renderable, unencoded form." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="HumanName.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="implied by XPN.11" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./formatted" />
            </mapping>
        </element>
        <element id="Patient.name.family">
            <path value="Patient.name.family" />
            <short value="Family name (often called &#39;Surname&#39;)" />
            <definition value="The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father." />
            <comment value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)." />
            <alias value="surname" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="HumanName.family" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XPN.1/FN.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./part[partType = FAM]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./FamilyName" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Surname" />
            </mapping>
        </element>
        <element id="Patient.name.given">
            <path value="Patient.name.given" />
            <short value="Given names (not always &#39;first&#39;). Includes middle names" />
            <definition value="Given name." />
            <comment value="If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren&#39;t due to paractical limitations.  This element is not called &quot;first name&quot; since given names do not always come first." />
            <alias value="first name" />
            <alias value="middle name" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="HumanName.given" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="string" />
            </type>
            <orderMeaning value="Patient.name.given[0] is expected to be the first name in a sequence. Patient.name.given[i], where i&gt;0, is expected to express a Patient&#39;s middle name(s)" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XPN.2 + XPN.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./part[partType = GIV]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./GivenNames" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Given Name" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Middle Name" />
            </mapping>
        </element>
        <element id="Patient.name.prefix">
            <path value="Patient.name.prefix" />
            <short value="Parts that come before the name" />
            <definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="HumanName.prefix" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="string" />
            </type>
            <orderMeaning value="Prefixes appear in the correct order for presenting the name" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XPN.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./part[partType = PFX]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./TitleCode" />
            </mapping>
        </element>
        <element id="Patient.name.suffix">
            <path value="Patient.name.suffix" />
            <short value="Parts that come after the name" />
            <definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="HumanName.suffix" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="string" />
            </type>
            <orderMeaning value="Suffixes appear in the correct order for presenting the name" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XPN/4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./part[partType = SFX]" />
            </mapping>
        </element>
        <element id="Patient.name.period">
            <path value="Patient.name.period" />
            <short value="Time period when name was/is in use" />
            <definition value="Indicates the period of time when this name was valid for the named person." />
            <requirements value="Allows names to be placed in historical context." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="HumanName.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XPN.13 + XPN.14" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.name.period.id">
            <path value="Patient.name.period.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.name.period.extension">
            <path value="Patient.name.period.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.name.period.start">
            <path value="Patient.name.period.start" />
            <short value="Starting time with inclusive boundary" />
            <definition value="The start of the period. The boundary is inclusive." />
            <comment value="This attribute is considered &#39;Recommended - No Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.start" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./low" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Effective Date" />
            </mapping>
        </element>
        <element id="Patient.name.period.end">
            <path value="Patient.name.period.end" />
            <short value="End time with inclusive boundary, if not ongoing" />
            <definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
            <comment value="This attribute is considered &#39;Recommended - Allow Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.end" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./high" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Expiry Date" />
            </mapping>
        </element>
        <element id="Patient.telecom">
            <path value="Patient.telecom" />
            <short value="A contact detail for the individual" />
            <definition value="A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted." />
            <comment value="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&#39;s phone)." />
            <requirements value="People have (primary) ways to contact them in some way such as phone, email." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.telecom" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="ContactPoint" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-13, PID-14, PID-40" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="telecom" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".telecom" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Contact Mechanism" />
            </mapping>
        </element>
        <element id="Patient.telecom.id">
            <path value="Patient.telecom.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.telecom.extension">
            <path value="Patient.telecom.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.telecom.system">
            <path value="Patient.telecom.system" />
            <short value="phone | fax | email | pager | url | sms | other" />
            <definition value="Telecommunications form for contact point - what communications system is required to make use of the contact." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ContactPoint.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="cpt-2" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ContactPointSystem" />
                </extension>
                <strength value="required" />
                <description value="Telecommunications form for contact point." />
                <valueSet value="http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="XTN.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./scheme" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./ContactPointType" />
            </mapping>
        </element>
        <element id="Patient.telecom.value">
            <path value="Patient.telecom.value" />
            <short value="The actual contact point details" />
            <definition value="The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address)." />
            <comment value="Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value." />
            <requirements value="Need to support legacy numbers that are not in a tightly controlled format." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ContactPoint.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XTN.1 (or XTN.12)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./url" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Value" />
            </mapping>
        </element>
        <element id="Patient.telecom.use">
            <path value="Patient.telecom.use" />
            <short value="home | work | temp | old | mobile - purpose of this contact point" />
            <definition value="Identifies the purpose for the contact point." />
            <comment value="Applications can assume that a contact is current unless it explicitly says that it is temporary or old." />
            <requirements value="Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ContactPoint.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old contact etc.for a current/permanent one" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ContactPointUse" />
                </extension>
                <strength value="required" />
                <description value="Use of contact point." />
                <valueSet value="http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="XTN.2 - but often indicated by field" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="unique(./use)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./ContactPointPurpose" />
            </mapping>
        </element>
        <element id="Patient.telecom.rank">
            <path value="Patient.telecom.rank" />
            <short value="Specify preferred order of use (1 = highest)" />
            <definition value="Specifies 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." />
            <comment value="Note that rank does not necessarily follow the order in which the contacts are represented in the instance." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ContactPoint.rank" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="positiveInt" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.telecom.period">
            <path value="Patient.telecom.period" />
            <short value="Time period when the contact point was/is in use" />
            <definition value="Time period when the contact point was/is in use." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ContactPoint.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.telecom.period.id">
            <path value="Patient.telecom.period.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.telecom.period.extension">
            <path value="Patient.telecom.period.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.telecom.period.start">
            <path value="Patient.telecom.period.start" />
            <short value="Starting time with inclusive boundary" />
            <definition value="The start of the period. The boundary is inclusive." />
            <comment value="If the low element is missing, the meaning is that the low boundary is not known." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.start" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./low" />
            </mapping>
        </element>
        <element id="Patient.telecom.period.end">
            <path value="Patient.telecom.period.end" />
            <short value="End time with inclusive boundary, if not ongoing" />
            <definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
            <comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Period.end" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
            <condition value="per-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="DR.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./high" />
            </mapping>
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <short value="The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation." />
            <definition value="The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation." />
            <comment value="The gender might not match the biological sex as determined by genetics or the individual&#39;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 &quot;hard&quot; error.  See the Patient Gender and Sex section for additional information about communicating patient gender and sex." />
            <requirements value="Needed for identification of the individual, in combination with (at least) name and birth date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.gender" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AdministrativeGender" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="required" />
                <description value="The gender of a person used for administrative purposes." />
                <valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="PID-8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".patient.administrativeGenderCode" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Gender Used" />
            </mapping>
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <short value="The date of birth for the individual" />
            <definition value="The date of birth for the individual." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <requirements value="Age of the individual drives many clinical processes." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.birthDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="date" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".patient.birthTime" />
            </mapping>
            <mapping>
                <identity value="loinc" />
                <map value="21112-8" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Birth Date" />
            </mapping>
        </element>
        <element id="Patient.birthDate.id">
            <path value="Patient.birthDate.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references)" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.birthDate.extension">
            <path value="Patient.birthDate.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="May 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.birthDate.extension:birthTime">
            <path value="Patient.birthDate.extension" />
            <sliceName value="birthTime" />
            <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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-birthTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.birthDate.value">
            <path value="Patient.birthDate.value" />
            <representation value="xmlAttr" />
            <short value="Primitive value for date" />
            <definition value="The actual value" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="date.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="date" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/regex">
                    <valueString value="([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.Date" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Patient.deceased[x]">
            <path value="Patient.deceased[x]" />
            <short value="Indicates if the individual is deceased or not" />
            <definition value="Indicates if the individual is deceased or not." />
            <comment value="If there&#39;s no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.deceased[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different." />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-30  (bool) and PID-29 (datetime)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Death" />
            </mapping>
        </element>
        <element id="Patient.address">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Patient.address" />
            <short value="An address expressed using postal conventions (as opposed to GPS or other location definition formats)" />
            <definition value="An address expressed using postal conventions (as opposed to GPS or other location definition formats).  This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery.  There are a variety of postal address formats defined around the world." />
            <comment value="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](location.html#) resource)." />
            <requirements value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.address" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Address" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/address-ca-core" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-11" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="addr" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".addr" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="XAD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="Address" />
            </mapping>
        </element>
        <element id="Patient.address.id">
            <path value="Patient.address.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.address.extension">
            <path value="Patient.address.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.address.use">
            <path value="Patient.address.use" />
            <short value="home | work | temp | old | billing - purpose of this address" />
            <definition value="The purpose of this address." />
            <comment value="Applications can assume that an address is current unless it explicitly says that it is temporary or old." />
            <requirements value="Allows an appropriate address to be chosen from a list of many." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <example>
                <label value="General" />
                <valueCode value="home" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old address etc.for a current/permanent one" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AddressUse" />
                </extension>
                <strength value="required" />
                <description value="The use of an address." />
                <valueSet value="http://hl7.org/fhir/ValueSet/address-use|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="XAD.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="unique(./use)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./AddressPurpose" />
            </mapping>
        </element>
        <element id="Patient.address.type">
            <path value="Patient.address.type" />
            <short value="postal | physical | both" />
            <definition value="Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both." />
            <comment value="The definition of Address states that &quot;address is intended to describe postal addresses, not physical locations&quot;. 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](location.html#) resource)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <example>
                <label value="General" />
                <valueCode value="both" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AddressType" />
                </extension>
                <strength value="required" />
                <description value="The type of an address (physical / postal)." />
                <valueSet value="http://hl7.org/fhir/ValueSet/address-type|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="XAD.18" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="unique(./use)" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="address type parameter" />
            </mapping>
        </element>
        <element id="Patient.address.text">
            <path value="Patient.address.text" />
            <short value="Text representation of the address" />
            <definition value="Specifies 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." />
            <comment value="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&#39;t found in a part." />
            <requirements value="A renderable, unencoded form." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="137 Nowhere Street, Erewhon 9132" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./formatted" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="address label parameter" />
            </mapping>
        </element>
        <element id="Patient.address.line">
            <path value="Patient.address.line" />
            <short value="Street name, number, direction &amp; P.O. Box etc." />
            <definition value="This component contains the house number, apartment number, street name, street direction,  P.O. Box number, delivery hints, and similar address information." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Address.line" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="string" />
            </type>
            <orderMeaning value="The order in which lines should appear in an address label" />
            <example>
                <label value="General" />
                <valueString value="137 Nowhere Street" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = AL]" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="street" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StreetAddress (newline delimitted)" />
            </mapping>
        </element>
        <element id="Patient.address.city">
            <path value="Patient.address.city" />
            <short value="Name of city, town etc." />
            <definition value="The name of the city, town, suburb, village or other community or delivery center." />
            <alias value="Municpality" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.city" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="Erewhon" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = CTY]" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="locality" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Jurisdiction" />
            </mapping>
        </element>
        <element id="Patient.address.district">
            <path value="Patient.address.district" />
            <short value="District name (aka county)" />
            <definition value="The name of the administrative area (county)." />
            <comment value="District is sometimes known as county, but in some regions &#39;county&#39; is used in place of city (municipality), so county name should be conveyed in city instead." />
            <alias value="County" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.district" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="Madison" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = CNT | CPA]" />
            </mapping>
        </element>
        <element id="Patient.address.state">
            <path value="Patient.address.state" />
            <short value="The Province or Territory of Canada, or Province, Territory of State of another country" />
            <definition value="The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA" />
            <alias value="Province" />
            <alias value="Territory" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.state" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = STA]" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="region" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Region" />
            </mapping>
        </element>
        <element id="Patient.address.postalCode">
            <path value="Patient.address.postalCode" />
            <short value="Postal code for area" />
            <definition value="A postal code designating a region defined by the postal service." />
            <alias value="Zip" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.postalCode" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="9132" />
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = ZIP]" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="code" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./PostalIdentificationCode" />
            </mapping>
        </element>
        <element id="Patient.address.country">
            <path value="Patient.address.country" />
            <short value="Recommend use of the HL7 Country ValueSet 3 letter code" />
            <definition value="Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html" />
            <comment value="ISO 3166 3 letter codes can be used in place of a human readable country name." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.country" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="AD.part[parttype = CNT]" />
            </mapping>
            <mapping>
                <identity value="vcard" />
                <map value="country" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Country" />
            </mapping>
        </element>
        <element id="Patient.address.period">
            <path value="Patient.address.period" />
            <short value="Time period when address was/is in use" />
            <definition value="Time period when address was/is in use." />
            <requirements value="Allows addresses to be placed in historical context." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Address.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <example>
                <label value="General" />
                <valuePeriod>
                    <start value="2010-03-23" />
                    <end value="2010-07-01" />
                </valuePeriod>
            </example>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="XAD.12 / XAD.13 + XAD.14" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="Patient.maritalStatus">
            <path value="Patient.maritalStatus" />
            <short value="Marital (civil) status of a patient" />
            <definition value="This field contains a patient&#39;s most recent marital (civil) status." />
            <requirements value="Most, if not all systems capture it." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.maritalStatus" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MaritalStatus" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="The domestic partnership status of a person." />
                <valueSet value="http://hl7.org/fhir/ValueSet/marital-status" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="PID-16" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN]/maritalStatusCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".patient.maritalStatusCode" />
            </mapping>
        </element>
        <element id="Patient.multipleBirth[x]">
            <path value="Patient.multipleBirth[x]" />
            <short value="Whether patient is part of a multiple birth" />
            <definition value="Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer)." />
            <comment value="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)." />
            <requirements value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn&#39;t meet the patient, such as labs." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.multipleBirth[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="integer" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="PID-24 (bool), PID-25 (integer)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.photo">
            <path value="Patient.photo" />
            <short value="Image of the patient" />
            <definition value="Image of the patient." />
            <comment value="Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates." />
            <requirements value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.photo" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Attachment" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 - needs a profile" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
                <valueString value="Contact" />
            </extension>
            <path value="Patient.contact" />
            <short value="A contact party (e.g. guardian, partner, friend) for the patient" />
            <definition value="A contact party (e.g. guardian, partner, friend) for the patient." />
            <comment value="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." />
            <requirements value="Need to track people you can contact about the patient." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.contact" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="pat-1" />
                <severity value="error" />
                <human value="SHALL at least contain a contact&#39;s details or a reference to an organization" />
                <expression value="name.exists() or telecom.exists() or address.exists() or organization.exists()" />
                <xpath value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.id">
            <path value="Patient.contact.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.extension">
            <path value="Patient.contact.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.modifierExtension">
            <path value="Patient.contact.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="May 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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.contact.relationship">
            <path value="Patient.contact.relationship" />
            <short value="The kind of relationship" />
            <definition value="The nature of the relationship between the patient and the contact person." />
            <requirements value="Used to determine which contact person is the most relevant to approach, depending on circumstances." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.contact.relationship" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ContactRelationship" />
                </extension>
                <strength value="extensible" />
                <description value="The nature of the relationship between a patient and a contact person for that patient." />
                <valueSet value="http://hl7.org/fhir/ValueSet/patient-contactrelationship" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="NK1-7, NK1-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="code" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.name">
            <path value="Patient.contact.name" />
            <short value="A name associated with the contact person" />
            <definition value="A name associated with the contact person." />
            <requirements value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.contact.name" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="HumanName" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="NK1-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="name" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.telecom">
            <path value="Patient.contact.telecom" />
            <short value="A contact detail for the person" />
            <definition value="A contact detail for the person, e.g. a telephone number or an email address." />
            <comment value="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." />
            <requirements value="People have (primary) ways to contact them in some way such as phone, email." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.contact.telecom" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="ContactPoint" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="NK1-5, NK1-6, NK1-40" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="telecom" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.address">
            <path value="Patient.contact.address" />
            <short value="Address for the contact person" />
            <definition value="Address for the contact person." />
            <requirements value="Need to keep track where the contact person can be contacted per postal mail or visited." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.contact.address" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Address" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="NK1-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="addr" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.gender">
            <path value="Patient.contact.gender" />
            <short value="male | female | other | unknown" />
            <definition value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes." />
            <requirements value="Needed to address the person correctly." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.contact.gender" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AdministrativeGender" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="required" />
                <description value="The gender of a person used for administrative purposes." />
                <valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="NK1-15" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.organization">
            <path value="Patient.contact.organization" />
            <short value="Organization that is associated with the contact" />
            <definition value="Organization on behalf of which the contact is acting or for which the contact is working." />
            <requirements value="For guardians or business related contacts, the organization is relevant." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.contact.organization" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="pat-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="NK1-13, NK1-30, NK1-31, NK1-32, NK1-41" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="scoper" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.contact.period">
            <path value="Patient.contact.period" />
            <short value="The period during which this contact person or organization is valid to be contacted relating to this patient" />
            <definition value="The period during which this contact person or organization is valid to be contacted relating to this patient." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.contact.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="effectiveTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication">
            <path value="Patient.communication" />
            <short value="A language which may be used to communicate with the patient about his or her health" />
            <definition value="A language which may be used to communicate with the patient about his or her health." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <requirements value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.communication" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="LanguageCommunication" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="patient.languageCommunication" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Service Language" />
            </mapping>
        </element>
        <element id="Patient.communication.id">
            <path value="Patient.communication.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.extension">
            <path value="Patient.communication.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.modifierExtension">
            <path value="Patient.communication.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="May 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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.communication.language">
            <path value="Patient.communication.language" />
            <short value="The language which can be used to communicate with the patient about his or her health" />
            <definition value="The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. &quot;en&quot; for English, or &quot;en-US&quot; for American English versus &quot;en-EN&quot; for England English." />
            <comment value="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." />
            <requirements value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Patient.communication.language" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="PID-15, LAN-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".languageCode" />
            </mapping>
        </element>
        <element id="Patient.communication.language.id">
            <path value="Patient.communication.language.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.language.extension">
            <path value="Patient.communication.language.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding">
            <path value="Patient.communication.language.coding" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
            <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.id">
            <path value="Patient.communication.language.coding.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.extension">
            <path value="Patient.communication.language.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.system">
            <path value="Patient.communication.language.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="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&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.version">
            <path value="Patient.communication.language.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="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." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.code">
            <path value="Patient.communication.language.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="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 value="Need to refer to a particular code in the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Service Language Code" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Patient.communication.language.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.userSelected">
            <path value="Patient.communication.language.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
            <comment value="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 &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="Patient.communication.language.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Patient.communication.language.text" />
            <short value="Plain text representation of the concept" />
            <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="Patient.communication.preferred">
            <path value="Patient.communication.preferred" />
            <short value="Language preference indicator" />
            <definition value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)." />
            <comment value="This language is specifically identified for communicating healthcare information." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.communication.preferred" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="PID-15" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="preferenceInd" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".preferenceInd" />
            </mapping>
        </element>
        <element id="Patient.generalPractitioner">
            <path value="Patient.generalPractitioner" />
            <short value="Patient&#39;s nominated primary care provider" />
            <definition value="Patient&#39;s nominated care provider." />
            <comment value="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.\nMultiple 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 &quot;fly-in/fly-out&quot; worker that has the onsite GP also included with his home GP to remain aware of medical issues.\n\nJurisdictions may decide that they can profile this down to 1 if desired, or 1 per type." />
            <alias value="careProvider" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.generalPractitioner" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="PD1-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="subjectOf.CareEvent.performer.AssignedEntity" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.managingOrganization">
            <path value="Patient.managingOrganization" />
            <short value="Organization that is the custodian of the patient record" />
            <definition value="Organization that is the custodian of the patient record." />
            <comment value="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)." />
            <requirements value="Need to know who recognizes this patient record, manages and updates it." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Patient.managingOrganization" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="scoper" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value=".providerOrganization" />
            </mapping>
        </element>
        <element id="Patient.link">
            <path value="Patient.link" />
            <short value="Link to another patient resource that concerns the same actual person" />
            <definition value="Link to another patient resource that concerns the same actual patient." />
            <comment value="There is no assumption that linked patient records have mutual links." />
            <requirements value="There are multiple use cases:   \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Patient.link" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is &#39;replaced-by&#39;" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="outboundLink" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.link.id">
            <path value="Patient.link.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.link.extension">
            <path value="Patient.link.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.link.modifierExtension">
            <path value="Patient.link.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="May 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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Patient.link.other">
            <path value="Patient.link.other" />
            <short value="The other patient or related person resource that the link refers to" />
            <definition value="The other patient resource that the link refers to." />
            <comment value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Patient.link.other" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy">
                    <valueBoolean value="false" />
                </extension>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="PID-3, MRG-1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Patient.link.type">
            <path value="Patient.link.type" />
            <short value="replaced-by | replaces | refer | seealso" />
            <definition value="The type of link between this patient resource and another patient resource." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Patient.link.type" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="LinkType" />
                </extension>
                <strength value="required" />
                <description value="The type of link between this patient resource and another patient resource." />
                <valueSet value="http://hl7.org/fhir/ValueSet/link-type|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="typeCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="n/a" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="Patient">
            <path value="Patient" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person*" />
                <comment value="*In the context of a person in a Party Role of Patient" />
            </mapping>
        </element>
        <element id="Patient.extension">
            <path value="Patient.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="Patient.extension:indigenousIdentity">
            <path value="Patient.extension" />
            <sliceName value="indigenousIdentity" />
            <short value="Extension for representing a code classifying a person&#39;s indigenous identity." />
            <definition value="A code classifying a person&#39;s self-identification as either First Nations, Inuk/Inuit and/or M&#233;tis." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core" />
            </type>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Indigenous Identity" />
            </mapping>
        </element>
        <element id="Patient.extension:racializedGroup">
            <path value="Patient.extension" />
            <sliceName value="racializedGroup" />
            <short value="Extension for representing a code classifying a person&#39;s racialized group." />
            <definition value="A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies." />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core" />
            </type>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Racialized Group" />
            </mapping>
        </element>
        <element id="Patient.extension:recordedSexOrGender">
            <path value="Patient.extension" />
            <sliceName value="recordedSexOrGender" />
            <short value="Recorded sex or gender (RSG) information includes the various sex and gender concepts." />
            <definition value="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender" />
            </type>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value">
            <path value="Patient.extension.extension" />
            <sliceName value="value" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:value.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/recordedgender" />
            </binding>
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type">
            <path value="Patient.extension.extension" />
            <sliceName value="type" />
        </element>
        <element id="Patient.extension:recordedSexOrGender.extension:type.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <patternCodeableConcept>
                <coding>
                    <system value="http://loinc.org" />
                    <code value="99502-7" />
                    <display value="Recorded sex or gender" />
                </coding>
            </patternCodeableConcept>
            <binding>
                <strength value="required" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype" />
            </binding>
        </element>
        <element id="Patient.extension:genderIdentity">
            <path value="Patient.extension" />
            <sliceName value="genderIdentity" />
            <short value="Extension for representing how the person prefers to self-describe." />
            <definition value="A code that specifies an individual&#39;s personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/individual-genderIdentity" />
            </type>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Gender Identity" />
            </mapping>
        </element>
        <element id="Patient.extension:genderIdentity.extension:value">
            <path value="Patient.extension.extension" />
            <sliceName value="value" />
        </element>
        <element id="Patient.extension:genderIdentity.extension:value.value[x]">
            <path value="Patient.extension.extension.value[x]" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode" />
            </binding>
        </element>
        <element id="Patient.extension:pronouns">
            <path value="Patient.extension" />
            <sliceName value="pronouns" />
            <short value="Third-person pronouns that may reference a person&#39;s gender identity (e.g. he, she, they)" />
            <definition value="A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person&#39;s gender identity (e.g. he, she, they) and that may be a part of their gender expression." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core" />
            </type>
        </element>
        <element id="Patient.extension:birthsex">
            <path value="Patient.extension" />
            <sliceName value="birthsex" />
            <short value="A code that specifies the sex of a person at birth which is a clinical finding" />
            <definition value="A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex" />
            </type>
        </element>
        <element id="Patient.extension:CommunicationBarrier">
            <path value="Patient.extension" />
            <sliceName value="CommunicationBarrier" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="type" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <requirements value="Patients are generally assigned specific alphanumeric identifiers." />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier" />
            </mapping>
        </element>
        <element id="Patient.identifier.type">
            <path value="Patient.identifier.type" />
            <min value="1" />
            <example>
                <label value="Jurisdictional Health Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="JHN" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="Medical Record Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="MR" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="Passport Number" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="PPN" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <example>
                <label value="National Unique Identifier (Placeholder Concept)" />
                <valueCodeableConcept>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                        <code value="NH" />
                    </coding>
                </valueCodeableConcept>
            </example>
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Type Code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier Type Code" />
            </mapping>
        </element>
        <element id="Patient.identifier.system">
            <path value="Patient.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier System" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="*Issued By" />
                <comment value="*Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner" />
            </mapping>
        </element>
        <element id="Patient.identifier.value">
            <path value="Patient.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Non-Health Identifier" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.start">
            <path value="Patient.identifier.period.start" />
            <comment value="This attribute is considered &#39;Recommended - No Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Effective Date" />
            </mapping>
        </element>
        <element id="Patient.identifier.period.end">
            <path value="Patient.identifier.period.end" />
            <comment value="This attribute is considered &#39;Recommended - Allow Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Health Identifier Expiry Date" />
            </mapping>
        </element>
        <element id="Patient.identifier.assigner">
            <path value="Patient.identifier.assigner" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Issued By" />
                <comment value="Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner" />
            </mapping>
        </element>
        <element id="Patient.identifier:JHN">
            <path value="Patient.identifier" />
            <sliceName value="JHN" />
            <short value="Jurisdictional Health Number" />
            <definition value="Patient and person health numbers used by all jurisdictions across Canada" />
            <min value="0" />
            <max value="*" />
        </element>
        <element id="Patient.identifier:JHN.extension:versionCode">
            <path value="Patient.identifier.extension" />
            <sliceName value="versionCode" />
            <short value="Health Number Version Code" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion" />
            </type>
        </element>
        <element id="Patient.identifier:JHN.type">
            <path value="Patient.identifier.type" />
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="JHN" />
                    <display value="Jurisdictional Health Number" />
                </coding>
            </patternCodeableConcept>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:JHN.system">
            <path value="Patient.identifier.system" />
            <short value="A Health Number Naming System from the Canadian URI Registry" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:JHN.value">
            <path value="Patient.identifier.value" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN">
            <path value="Patient.identifier" />
            <sliceName value="MRN" />
            <short value="Medical Record Number" />
            <definition value="A local patient identifier from the submitting PoS System" />
            <comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
            <min value="0" />
            <max value="*" />
        </element>
        <element id="Patient.identifier:MRN.type">
            <path value="Patient.identifier.type" />
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="MR" />
                    <display value="Medical Record Number" />
                </coding>
            </patternCodeableConcept>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN.system">
            <path value="Patient.identifier.system" />
            <short value="An identifier for the system supplying the MRN" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN.value">
            <path value="Patient.identifier.value" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.active">
            <path value="Patient.active" />
            <comment value="it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients" />
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided" />
            <min value="1" />
            <constraint>
                <key value="ca-core-pat-1" />
                <severity value="error" />
                <human value="Either Patient.name.given and/or Patient.name.family SHALL be present." />
                <expression value="(family.exists() or given.exists())" />
                <xpath value="(/f:name/f:family or /f:name/f:given)" />
                <source value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name" />
            </mapping>
        </element>
        <element id="Patient.name.use">
            <path value="Patient.name.use" />
            <min value="1" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Type Code" />
            </mapping>
        </element>
        <element id="Patient.name.text">
            <path value="Patient.name.text" />
            <definition value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element" />
            <comment value="Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance" />
        </element>
        <element id="Patient.name.family">
            <path value="Patient.name.family" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Surname" />
            </mapping>
        </element>
        <element id="Patient.name.given">
            <path value="Patient.name.given" />
            <orderMeaning value="Patient.name.given[0] is expected to be the first name in a sequence. Patient.name.given[i], where i&gt;0, is expected to express a Patient&#39;s middle name(s)" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Given Name" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Middle Name" />
            </mapping>
        </element>
        <element id="Patient.name.period.start">
            <path value="Patient.name.period.start" />
            <comment value="This attribute is considered &#39;Recommended - No Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Effective Date" />
            </mapping>
        </element>
        <element id="Patient.name.period.end">
            <path value="Patient.name.period.end" />
            <comment value="This attribute is considered &#39;Recommended - Allow Absent&#39; in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR)." />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Name Expiry Date" />
            </mapping>
        </element>
        <element id="Patient.telecom">
            <path value="Patient.telecom" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Contact Mechanism" />
            </mapping>
        </element>
        <element id="Patient.telecom.system">
            <path value="Patient.telecom.system" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.value">
            <path value="Patient.telecom.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.use">
            <path value="Patient.telecom.use" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.period.end">
            <path value="Patient.telecom.period.end" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <short value="The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation." />
            <definition value="The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation." />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Gender Used" />
            </mapping>
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Birth Date" />
            </mapping>
        </element>
        <element id="Patient.birthDate.extension">
            <path value="Patient.birthDate.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="Patient.birthDate.extension:birthTime">
            <path value="Patient.birthDate.extension" />
            <sliceName value="birthTime" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/patient-birthTime" />
            </type>
        </element>
        <element id="Patient.deceased[x]">
            <path value="Patient.deceased[x]" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Person Death" />
            </mapping>
        </element>
        <element id="Patient.address">
            <path value="Patient.address" />
            <type>
                <code value="Address" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/address-ca-core" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.line">
            <path value="Patient.address.line" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.city">
            <path value="Patient.address.city" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.postalCode">
            <path value="Patient.address.postalCode" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.country">
            <path value="Patient.address.country" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.communication">
            <path value="Patient.communication" />
            <comment value="This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element." />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Service Language" />
            </mapping>
        </element>
        <element id="Patient.communication.language.coding.code">
            <path value="Patient.communication.language.coding.code" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Party Service Language Code" />
            </mapping>
        </element>
        <element id="Patient.generalPractitioner">
            <path value="Patient.generalPractitioner" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Patient.managingOrganization">
            <path value="Patient.managingOrganization" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "patient-ca-core",
    "url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
    "name": "PatientCACore",
    "title": "Patient (CA-Core)",
    "status": "draft",
    "experimental": false,
    "date": "2025-03-17",
    "publisher": "Canada Health Infoway",
    "contact":  [
        {
            "name": "National Standards Release Centre",
            "telecom":  [
                {
                    "system": "url",
                    "value": "http://www.infoway-inforoute.ca"
                },
                {
                    "system": "email",
                    "value": "standards@infoway-inforoute.ca"
                }
            ]
        }
    ],
    "description": "This profile applies constraints to the Patient resource for CA Core+ to support identity, demographics, and administrative data in the pan-Canadian context.",
    "jurisdiction":  [
        {
            "coding":  [
                {
                    "system": "urn:iso:std:iso:3166",
                    "code": "CA"
                }
            ]
        }
    ],
    "copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "pCHDCF-CACDI",
            "name": "Pan-Canadian Health Data Content Framework - CACDI"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "snapshot": {
        "element":  [
            {
                "id": "Patient",
                "path": "Patient",
                "short": "Information about an individual or animal receiving health care services",
                "definition": "Demographics and other administrative information about an individual or animal receiving care or other health-related services.",
                "alias":  [
                    "SubjectOfCare Client Resident"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "human": "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",
                        "expression": "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()",
                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-5",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
                        "expression": "contained.meta.security.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                                "valueBoolean": true
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
                            }
                        ],
                        "key": "dom-6",
                        "severity": "warning",
                        "human": "A resource should have narrative for robust management",
                        "expression": "text.`div`.exists()",
                        "xpath": "exists(f:text/h:div)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "rim",
                        "map": "Patient[classCode=PAT]"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument.recordTarget.patientRole"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person*",
                        "comment": "*In the context of a person in a Party Role of Patient"
                    }
                ]
            },
            {
                "id": "Patient.id",
                "path": "Patient.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "Patient.meta",
                "path": "Patient.meta",
                "short": "Metadata about the resource",
                "definition": "The 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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "Patient.implicitRules",
                "path": "Patient.implicitRules",
                "short": "A set of rules under which this content was created",
                "definition": "A 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.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
                "isSummary": true
            },
            {
                "id": "Patient.language",
                "path": "Patient.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "comment": "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                }
            },
            {
                "id": "Patient.text",
                "path": "Patient.text",
                "short": "Text summary of the resource, for human interpretation",
                "definition": "A 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.",
                "comment": "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.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "Patient.contained",
                "path": "Patient.contained",
                "short": "Contained, inline Resources",
                "definition": "These 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.",
                "comment": "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.",
                "alias":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension",
                "path": "Patient.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "May 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:indigenousIdentity",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.extension",
                "sliceName": "indigenousIdentity",
                "short": "Extension for representing a code classifying a person's indigenous identity.",
                "definition": "A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Indigenous Identity"
                    }
                ]
            },
            {
                "id": "Patient.extension:racializedGroup",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.extension",
                "sliceName": "racializedGroup",
                "short": "Extension for representing a code classifying a person's racialized group.",
                "definition": "A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Racialized Group"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender",
                "path": "Patient.extension",
                "sliceName": "recordedSexOrGender",
                "short": "Recorded sex or gender (RSG) information includes the various sex and gender concepts.",
                "definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.id",
                "path": "Patient.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension",
                "path": "Patient.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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 managable, 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 1,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value",
                "path": "Patient.extension.extension",
                "sliceName": "value",
                "short": "The recorded sex or gender property for the individual",
                "definition": "A sex or gender property for the individual from a document or other record",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "value",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "recordedSexOrGender"
                        }
                    ],
                    "strength": "extensible",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgender"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type",
                "path": "Patient.extension.extension",
                "sliceName": "type",
                "short": "Type of recorded sex or gender.",
                "definition": "The type or category of sex or gender that is recorded.",
                "comment": "Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "type",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://loinc.org",
                            "code": "99502-7",
                            "display": "Recorded sex or gender"
                        }
                    ]
                },
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "recordedSexOrGenderType"
                        }
                    ],
                    "strength": "required",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:effectivePeriod",
                "path": "Patient.extension.extension",
                "sliceName": "effectivePeriod",
                "short": "When the recorded sex or gender value applies",
                "definition": "The time period during which the recorded sex or gender value applies to the individual",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:effectivePeriod.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:effectivePeriod.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "effectivePeriod",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:effectivePeriod.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:acquisitionDate",
                "path": "Patient.extension.extension",
                "sliceName": "acquisitionDate",
                "short": "When the sex or gender value was recorded.",
                "definition": "The date/time when the sex or gender value was first recorded in the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:acquisitionDate.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:acquisitionDate.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "acquisitionDate",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:acquisitionDate.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceDocument",
                "path": "Patient.extension.extension",
                "sliceName": "sourceDocument",
                "short": "The document the sex or gender property was acquired from.",
                "definition": "The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded.",
                "comment": "For example, if a driver's license is scanned, this property may reference that scanned document.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceDocument.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceDocument.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceDocument.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "sourceDocument",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceDocument.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/DocumentReference"
                        ]
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceField",
                "path": "Patient.extension.extension",
                "sliceName": "sourceField",
                "short": "The name of the field within the source document where this sex or gender property is initially recorded.",
                "definition": "The name of the field within the source document where this sex or gender property is initially recorded.",
                "comment": "For example, if a sex value is acquired from a driver's license, and the name of the field on that driver's license is 'SEX', then a code describing that field can be provided.  If the semantics of the field are known, they may be described in the comment.  For example, if the 'SEX' field on a license in a particular state or province is populated based on an individual's indication of what gender they consider themselves to be, but the field label is 'SEX' for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is 'SEX' can be provided.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceField.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceField.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceField.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "sourceField",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:sourceField.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:jurisdiction",
                "path": "Patient.extension.extension",
                "sliceName": "jurisdiction",
                "short": "Who issued the document where the sex or gender was aquired",
                "definition": "The jurisdiction or organization that issued the document from which the sex or gender was aquired",
                "comment": "For example, a individual's driver's license or passport would be issued by a specific state or country.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:jurisdiction.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:jurisdiction.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:jurisdiction.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "jurisdiction",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:jurisdiction.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Jurisdiction ValueSet"
                        }
                    ],
                    "strength": "extensible",
                    "valueSet": "http://terminology.hl7.org/ValueSet/jurisdiction"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:comment",
                "path": "Patient.extension.extension",
                "sliceName": "comment",
                "short": "Context or source information about the recorded sex or gender",
                "definition": "Further explanation about the context or source of the recorded sex or gender value",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:comment.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:comment.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:comment.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "comment",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:comment.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:genderElementQualifier",
                "path": "Patient.extension.extension",
                "sliceName": "genderElementQualifier",
                "short": "Whether this recorded sex or gender value qualifies the .gender element.",
                "definition": "Instances of the individual-recordedSexOrGender extension with this value set to 'true' provides additional semantics or provenance of the data communicated in the relevant '.gender' property in the resource.  For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:genderElementQualifier.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:genderElementQualifier.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "genderElementQualifier",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:genderElementQualifier.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.url",
                "path": "Patient.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "uri"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "fixedUri": "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.value[x]",
                "path": "Patient.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "base64Binary"
                    },
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "canonical"
                    },
                    {
                        "code": "code"
                    },
                    {
                        "code": "date"
                    },
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "decimal"
                    },
                    {
                        "code": "id"
                    },
                    {
                        "code": "instant"
                    },
                    {
                        "code": "integer"
                    },
                    {
                        "code": "integer64"
                    },
                    {
                        "code": "markdown"
                    },
                    {
                        "code": "oid"
                    },
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "time"
                    },
                    {
                        "code": "unsignedInt"
                    },
                    {
                        "code": "uri"
                    },
                    {
                        "code": "url"
                    },
                    {
                        "code": "uuid"
                    },
                    {
                        "code": "Address"
                    },
                    {
                        "code": "Age"
                    },
                    {
                        "code": "Annotation"
                    },
                    {
                        "code": "Attachment"
                    },
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "CodeableReference"
                    },
                    {
                        "code": "Coding"
                    },
                    {
                        "code": "ContactPoint"
                    },
                    {
                        "code": "Count"
                    },
                    {
                        "code": "Distance"
                    },
                    {
                        "code": "Duration"
                    },
                    {
                        "code": "HumanName"
                    },
                    {
                        "code": "Identifier"
                    },
                    {
                        "code": "Money"
                    },
                    {
                        "code": "Period"
                    },
                    {
                        "code": "Quantity"
                    },
                    {
                        "code": "Range"
                    },
                    {
                        "code": "Ratio"
                    },
                    {
                        "code": "RatioRange"
                    },
                    {
                        "code": "Reference"
                    },
                    {
                        "code": "SampledData"
                    },
                    {
                        "code": "Signature"
                    },
                    {
                        "code": "Timing"
                    },
                    {
                        "code": "ContactDetail"
                    },
                    {
                        "code": "DataRequirement"
                    },
                    {
                        "code": "Expression"
                    },
                    {
                        "code": "ParameterDefinition"
                    },
                    {
                        "code": "RelatedArtifact"
                    },
                    {
                        "code": "TriggerDefinition"
                    },
                    {
                        "code": "UsageContext"
                    },
                    {
                        "code": "Availability"
                    },
                    {
                        "code": "ExtendedContactDetail"
                    },
                    {
                        "code": "Dosage"
                    },
                    {
                        "code": "Meta"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity",
                "path": "Patient.extension",
                "sliceName": "genderIdentity",
                "short": "Extension for representing how the person prefers to self-describe.",
                "definition": "A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings.",
                "comment": "This represents an individual’s identity, ascertained by asking them what that identity is.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Gender Identity"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.id",
                "path": "Patient.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension",
                "path": "Patient.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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 managable, 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 1,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value",
                "path": "Patient.extension.extension",
                "sliceName": "value",
                "short": "The individual's gender identity",
                "definition": "An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.",
                "comment": "This represents an individual’s identity, ascertained by asking them what that identity is.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "value",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "GenderIdentity"
                        }
                    ],
                    "strength": "extensible",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:period",
                "path": "Patient.extension.extension",
                "sliceName": "period",
                "short": "The time period during which the gender identity applies to the individual",
                "definition": "The time period during which the gender identity applies to the individual",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:period.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:period.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:period.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "period",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:period.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:comment",
                "path": "Patient.extension.extension",
                "sliceName": "comment",
                "short": "Text to further explain the use of the specified gender identity",
                "definition": "Text to further explain the use of the specified gender identity",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:comment.id",
                "path": "Patient.extension.extension.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "id"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:comment.extension",
                "path": "Patient.extension.extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extension",
                "definition": "An Extension",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.extension:genderIdentity.extension:comment.url",
                "path": "Patient.extension.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "comment",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:comment.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.url",
                "path": "Patient.extension.url",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "identifies the meaning of the extension",
                "definition": "Source of the definition for the extension code - a logical name or a URL.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Extension.url",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "uri"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "fixedUri": "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity",
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.value[x]",
                "path": "Patient.extension.value[x]",
                "short": "Value of extension",
                "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Extension.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "base64Binary"
                    },
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "canonical"
                    },
                    {
                        "code": "code"
                    },
                    {
                        "code": "date"
                    },
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "decimal"
                    },
                    {
                        "code": "id"
                    },
                    {
                        "code": "instant"
                    },
                    {
                        "code": "integer"
                    },
                    {
                        "code": "integer64"
                    },
                    {
                        "code": "markdown"
                    },
                    {
                        "code": "oid"
                    },
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "time"
                    },
                    {
                        "code": "unsignedInt"
                    },
                    {
                        "code": "uri"
                    },
                    {
                        "code": "url"
                    },
                    {
                        "code": "uuid"
                    },
                    {
                        "code": "Address"
                    },
                    {
                        "code": "Age"
                    },
                    {
                        "code": "Annotation"
                    },
                    {
                        "code": "Attachment"
                    },
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "CodeableReference"
                    },
                    {
                        "code": "Coding"
                    },
                    {
                        "code": "ContactPoint"
                    },
                    {
                        "code": "Count"
                    },
                    {
                        "code": "Distance"
                    },
                    {
                        "code": "Duration"
                    },
                    {
                        "code": "HumanName"
                    },
                    {
                        "code": "Identifier"
                    },
                    {
                        "code": "Money"
                    },
                    {
                        "code": "Period"
                    },
                    {
                        "code": "Quantity"
                    },
                    {
                        "code": "Range"
                    },
                    {
                        "code": "Ratio"
                    },
                    {
                        "code": "RatioRange"
                    },
                    {
                        "code": "Reference"
                    },
                    {
                        "code": "SampledData"
                    },
                    {
                        "code": "Signature"
                    },
                    {
                        "code": "Timing"
                    },
                    {
                        "code": "ContactDetail"
                    },
                    {
                        "code": "DataRequirement"
                    },
                    {
                        "code": "Expression"
                    },
                    {
                        "code": "ParameterDefinition"
                    },
                    {
                        "code": "RelatedArtifact"
                    },
                    {
                        "code": "TriggerDefinition"
                    },
                    {
                        "code": "UsageContext"
                    },
                    {
                        "code": "Availability"
                    },
                    {
                        "code": "ExtendedContactDetail"
                    },
                    {
                        "code": "Dosage"
                    },
                    {
                        "code": "Meta"
                    }
                ],
                "condition":  [
                    "ext-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.extension:pronouns",
                "path": "Patient.extension",
                "sliceName": "pronouns",
                "short": "Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)",
                "definition": "A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression.",
                "comment": "This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF",
                        "map": "Pronouns"
                    }
                ]
            },
            {
                "id": "Patient.extension:birthsex",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.extension",
                "sliceName": "birthsex",
                "short": "A code that specifies the sex of a person at birth which is a clinical finding",
                "definition": "A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.extension:CommunicationBarrier",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.extension",
                "sliceName": "CommunicationBarrier",
                "short": "Optional Extensions Element",
                "definition": "Optional Extension Element - found in all resources.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.modifierExtension",
                "path": "Patient.modifierExtension",
                "short": "Extensions that cannot be ignored",
                "definition": "May 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "type"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "An identifier for this patient",
                "definition": "An identifier for this patient.",
                "requirements": "Patients are generally assigned specific alphanumeric identifiers.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3"
                    },
                    {
                        "identity": "rim",
                        "map": "id"
                    },
                    {
                        "identity": "cda",
                        "map": ".id"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier"
                    }
                ]
            },
            {
                "id": "Patient.identifier.id",
                "path": "Patient.identifier.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier.extension",
                "path": "Patient.identifier.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier.use",
                "path": "Patient.identifier.use",
                "short": "usual | official | temp | secondary | old (If known)",
                "definition": "The purpose of this identifier.",
                "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierUse"
                        }
                    ],
                    "strength": "required",
                    "description": "Identifies the purpose for this identifier, if known .",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "Patient.identifier.type",
                "path": "Patient.identifier.type",
                "short": "Description of identifier",
                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
                "comment": "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.",
                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Identifier.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "example":  [
                    {
                        "label": "Jurisdictional Health Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "JHN"
                                }
                            ]
                        }
                    },
                    {
                        "label": "Medical Record Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MR"
                                }
                            ]
                        }
                    },
                    {
                        "label": "Passport Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "PPN"
                                }
                            ]
                        }
                    },
                    {
                        "label": "National Unique Identifier (Placeholder Concept)",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "NH"
                                }
                            ]
                        }
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierType"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.5"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Type Code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier Type Code"
                    }
                ]
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "short": "The namespace for the identifier value",
                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
                "comment": "Identifier.system is always case sensitive.",
                "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Identifier.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueUri": "http://www.acme.com/identifiers/patient"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / EI-2-4"
                    },
                    {
                        "identity": "rim",
                        "map": "II.root or Role.id.root"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierType"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier System"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "*Issued By",
                        "comment": "*Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner"
                    }
                ]
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "short": "The value that is unique",
                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
                "comment": "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](extension-rendered-value.html). 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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Identifier.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "123456"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.1 / EI.1"
                    },
                    {
                        "identity": "rim",
                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
                    },
                    {
                        "identity": "servd",
                        "map": "./Value"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period",
                "path": "Patient.identifier.period",
                "short": "Time period when id is/was valid for use",
                "definition": "Time period during which identifier is/was valid for use.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.7 + CX.8"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.effectiveTime or implied by context"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.id",
                "path": "Patient.identifier.period.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.extension",
                "path": "Patient.identifier.period.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.start",
                "path": "Patient.identifier.period.start",
                "short": "Starting time with inclusive boundary",
                "definition": "The start of the period. The boundary is inclusive.",
                "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.start",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./low"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Effective Date"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.end",
                "path": "Patient.identifier.period.end",
                "short": "End time with inclusive boundary, if not ongoing",
                "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
                "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.end",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.2"
                    },
                    {
                        "identity": "rim",
                        "map": "./high"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Expiry Date"
                    }
                ]
            },
            {
                "id": "Patient.identifier.assigner",
                "path": "Patient.identifier.assigner",
                "short": "Organization that issued id (may be just text)",
                "definition": "Organization that issued/manages the identifier.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.assigner",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
                    },
                    {
                        "identity": "rim",
                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierIssuingAuthority"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Issued By",
                        "comment": "Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN",
                "path": "Patient.identifier",
                "sliceName": "JHN",
                "short": "Jurisdictional Health Number",
                "definition": "Patient and person health numbers used by all jurisdictions across Canada",
                "requirements": "Patients are almost always assigned specific numerical identifiers.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3"
                    },
                    {
                        "identity": "rim",
                        "map": "id"
                    },
                    {
                        "identity": "cda",
                        "map": ".id"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.id",
                "path": "Patient.identifier.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.extension",
                "path": "Patient.identifier.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.extension:versionCode",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.identifier.extension",
                "sliceName": "versionCode",
                "short": "Health Number Version Code",
                "definition": "Optional Extension Element - found in all resources.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.use",
                "path": "Patient.identifier.use",
                "short": "usual | official | temp | secondary | old (If known)",
                "definition": "The purpose of this identifier.",
                "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierUse"
                        }
                    ],
                    "strength": "required",
                    "description": "Identifies the purpose for this identifier, if known .",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.type",
                "path": "Patient.identifier.type",
                "short": "Description of identifier",
                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
                "comment": "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.",
                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "JHN",
                            "display": "Jurisdictional Health Number"
                        }
                    ]
                },
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierType"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.5"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.system",
                "path": "Patient.identifier.system",
                "short": "A Health Number Naming System from the Canadian URI Registry",
                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
                "comment": "Identifier.system is always case sensitive.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueUri": "http://www.acme.com/identifiers/patient"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / EI-2-4"
                    },
                    {
                        "identity": "rim",
                        "map": "II.root or Role.id.root"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierType"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.value",
                "path": "Patient.identifier.value",
                "short": "The value that is unique",
                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
                "comment": "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](extension-rendered-value.html). 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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "123456"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.1 / EI.1"
                    },
                    {
                        "identity": "rim",
                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
                    },
                    {
                        "identity": "servd",
                        "map": "./Value"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.period",
                "path": "Patient.identifier.period",
                "short": "Time period when id is/was valid for use",
                "definition": "Time period during which identifier is/was valid for use.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.7 + CX.8"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.effectiveTime or implied by context"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.assigner",
                "path": "Patient.identifier.assigner",
                "short": "Organization that issued id (may be just text)",
                "definition": "Organization that issued/manages the identifier.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.assigner",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
                    },
                    {
                        "identity": "rim",
                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierIssuingAuthority"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN",
                "path": "Patient.identifier",
                "sliceName": "MRN",
                "short": "Medical Record Number",
                "definition": "A local patient identifier from the submitting PoS System",
                "comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
                "requirements": "Patients are almost always assigned specific numerical identifiers.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3"
                    },
                    {
                        "identity": "rim",
                        "map": "id"
                    },
                    {
                        "identity": "cda",
                        "map": ".id"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.id",
                "path": "Patient.identifier.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.extension",
                "path": "Patient.identifier.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.use",
                "path": "Patient.identifier.use",
                "short": "usual | official | temp | secondary | old (If known)",
                "definition": "The purpose of this identifier.",
                "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierUse"
                        }
                    ],
                    "strength": "required",
                    "description": "Identifies the purpose for this identifier, if known .",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.type",
                "path": "Patient.identifier.type",
                "short": "Description of identifier",
                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
                "comment": "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.",
                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "MR",
                            "display": "Medical Record Number"
                        }
                    ]
                },
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierType"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.5"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.system",
                "path": "Patient.identifier.system",
                "short": "An identifier for the system supplying the MRN",
                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
                "comment": "Identifier.system is always case sensitive.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueUri": "http://www.acme.com/identifiers/patient"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / EI-2-4"
                    },
                    {
                        "identity": "rim",
                        "map": "II.root or Role.id.root"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierType"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.value",
                "path": "Patient.identifier.value",
                "short": "The value that is unique",
                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
                "comment": "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](extension-rendered-value.html). 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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "123456"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.1 / EI.1"
                    },
                    {
                        "identity": "rim",
                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
                    },
                    {
                        "identity": "servd",
                        "map": "./Value"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.period",
                "path": "Patient.identifier.period",
                "short": "Time period when id is/was valid for use",
                "definition": "Time period during which identifier is/was valid for use.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.7 + CX.8"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.effectiveTime or implied by context"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.identifier:MRN.assigner",
                "path": "Patient.identifier.assigner",
                "short": "Organization that issued id (may be just text)",
                "definition": "Organization that issued/manages the identifier.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.assigner",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
                    },
                    {
                        "identity": "rim",
                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierIssuingAuthority"
                    }
                ]
            },
            {
                "id": "Patient.active",
                "path": "Patient.active",
                "short": "Whether this patient's record is in active use",
                "definition": "Whether this patient record is in active use. \nMany 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.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.",
                "comment": "it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients",
                "requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.active",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": "statusCode"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "short": "A name associated with the patient",
                "definition": "A name associated with the individual.",
                "comment": "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.",
                "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "Patient.name",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "HumanName"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ca-core-pat-1",
                        "severity": "error",
                        "human": "Either Patient.name.given and/or Patient.name.family SHALL be present.",
                        "expression": "(family.exists() or given.exists())",
                        "xpath": "(/f:name/f:family or /f:name/f:given)",
                        "source": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-5, PID-9"
                    },
                    {
                        "identity": "rim",
                        "map": "name"
                    },
                    {
                        "identity": "cda",
                        "map": ".patient.name"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name"
                    }
                ]
            },
            {
                "id": "Patient.name.id",
                "path": "Patient.name.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.name.extension",
                "path": "Patient.name.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.name.use",
                "path": "Patient.name.use",
                "short": "usual | official | temp | nickname | anonymous | old | maiden",
                "definition": "Identifies the purpose for this name.",
                "comment": "Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
                "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "HumanName.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "NameUse"
                        }
                    ],
                    "strength": "required",
                    "description": "The use of a human name.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/name-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN.7, but often indicated by which field contains the name"
                    },
                    {
                        "identity": "rim",
                        "map": "unique(./use)"
                    },
                    {
                        "identity": "servd",
                        "map": "./NamePurpose"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Type Code"
                    }
                ]
            },
            {
                "id": "Patient.name.text",
                "path": "Patient.name.text",
                "short": "Text representation of the full name",
                "definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
                "comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance",
                "requirements": "A renderable, unencoded form.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "HumanName.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "implied by XPN.11"
                    },
                    {
                        "identity": "rim",
                        "map": "./formatted"
                    }
                ]
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "short": "Family name (often called 'Surname')",
                "definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
                "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
                "alias":  [
                    "surname"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "HumanName.family",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN.1/FN.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./part[partType = FAM]"
                    },
                    {
                        "identity": "servd",
                        "map": "./FamilyName"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Surname"
                    }
                ]
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "short": "Given names (not always 'first'). Includes middle names",
                "definition": "Given name.",
                "comment": "If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations.  This element is not called \"first name\" since given names do not always come first.",
                "alias":  [
                    "first name",
                    "middle name"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "HumanName.given",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "orderMeaning": "Patient.name.given[0] is expected to be the first name in a sequence. Patient.name.given[i], where i>0, is expected to express a Patient's middle name(s)",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN.2 + XPN.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./part[partType = GIV]"
                    },
                    {
                        "identity": "servd",
                        "map": "./GivenNames"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Given Name"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Middle Name"
                    }
                ]
            },
            {
                "id": "Patient.name.prefix",
                "path": "Patient.name.prefix",
                "short": "Parts that come before the name",
                "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "HumanName.prefix",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "orderMeaning": "Prefixes appear in the correct order for presenting the name",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN.5"
                    },
                    {
                        "identity": "rim",
                        "map": "./part[partType = PFX]"
                    },
                    {
                        "identity": "servd",
                        "map": "./TitleCode"
                    }
                ]
            },
            {
                "id": "Patient.name.suffix",
                "path": "Patient.name.suffix",
                "short": "Parts that come after the name",
                "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "HumanName.suffix",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "orderMeaning": "Suffixes appear in the correct order for presenting the name",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN/4"
                    },
                    {
                        "identity": "rim",
                        "map": "./part[partType = SFX]"
                    }
                ]
            },
            {
                "id": "Patient.name.period",
                "path": "Patient.name.period",
                "short": "Time period when name was/is in use",
                "definition": "Indicates the period of time when this name was valid for the named person.",
                "requirements": "Allows names to be placed in historical context.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "HumanName.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XPN.13 + XPN.14"
                    },
                    {
                        "identity": "rim",
                        "map": "./usablePeriod[type=\"IVL<TS>\"]"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.name.period.id",
                "path": "Patient.name.period.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.name.period.extension",
                "path": "Patient.name.period.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.name.period.start",
                "path": "Patient.name.period.start",
                "short": "Starting time with inclusive boundary",
                "definition": "The start of the period. The boundary is inclusive.",
                "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.start",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./low"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Effective Date"
                    }
                ]
            },
            {
                "id": "Patient.name.period.end",
                "path": "Patient.name.period.end",
                "short": "End time with inclusive boundary, if not ongoing",
                "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
                "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.end",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.2"
                    },
                    {
                        "identity": "rim",
                        "map": "./high"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Expiry Date"
                    }
                ]
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "short": "A contact detail for the individual",
                "definition": "A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.",
                "comment": "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).",
                "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.telecom",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "ContactPoint"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-13, PID-14, PID-40"
                    },
                    {
                        "identity": "rim",
                        "map": "telecom"
                    },
                    {
                        "identity": "cda",
                        "map": ".telecom"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Contact Mechanism"
                    }
                ]
            },
            {
                "id": "Patient.telecom.id",
                "path": "Patient.telecom.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.telecom.extension",
                "path": "Patient.telecom.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.telecom.system",
                "path": "Patient.telecom.system",
                "short": "phone | fax | email | pager | url | sms | other",
                "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "ContactPoint.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "cpt-2"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ContactPointSystem"
                        }
                    ],
                    "strength": "required",
                    "description": "Telecommunications form for contact point.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XTN.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./scheme"
                    },
                    {
                        "identity": "servd",
                        "map": "./ContactPointType"
                    }
                ]
            },
            {
                "id": "Patient.telecom.value",
                "path": "Patient.telecom.value",
                "short": "The actual contact point details",
                "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
                "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
                "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "ContactPoint.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XTN.1 (or XTN.12)"
                    },
                    {
                        "identity": "rim",
                        "map": "./url"
                    },
                    {
                        "identity": "servd",
                        "map": "./Value"
                    }
                ]
            },
            {
                "id": "Patient.telecom.use",
                "path": "Patient.telecom.use",
                "short": "home | work | temp | old | mobile - purpose of this contact point",
                "definition": "Identifies the purpose for the contact point.",
                "comment": "Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
                "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "ContactPoint.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ContactPointUse"
                        }
                    ],
                    "strength": "required",
                    "description": "Use of contact point.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XTN.2 - but often indicated by field"
                    },
                    {
                        "identity": "rim",
                        "map": "unique(./use)"
                    },
                    {
                        "identity": "servd",
                        "map": "./ContactPointPurpose"
                    }
                ]
            },
            {
                "id": "Patient.telecom.rank",
                "path": "Patient.telecom.rank",
                "short": "Specify preferred order of use (1 = highest)",
                "definition": "Specifies 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.",
                "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "ContactPoint.rank",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "positiveInt"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.telecom.period",
                "path": "Patient.telecom.period",
                "short": "Time period when the contact point was/is in use",
                "definition": "Time period when the contact point was/is in use.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "ContactPoint.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "./usablePeriod[type=\"IVL<TS>\"]"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.telecom.period.id",
                "path": "Patient.telecom.period.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.telecom.period.extension",
                "path": "Patient.telecom.period.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.telecom.period.start",
                "path": "Patient.telecom.period.start",
                "short": "Starting time with inclusive boundary",
                "definition": "The start of the period. The boundary is inclusive.",
                "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.start",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./low"
                    }
                ]
            },
            {
                "id": "Patient.telecom.period.end",
                "path": "Patient.telecom.period.end",
                "short": "End time with inclusive boundary, if not ongoing",
                "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
                "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Period.end",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
                "condition":  [
                    "per-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "DR.2"
                    },
                    {
                        "identity": "rim",
                        "map": "./high"
                    }
                ]
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "short": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.",
                "definition": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.",
                "comment": "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.",
                "requirements": "Needed for identification of the individual, in combination with (at least) name and birth date.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.gender",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AdministrativeGender"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "required",
                    "description": "The gender of a person used for administrative purposes.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-8"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
                    },
                    {
                        "identity": "cda",
                        "map": ".patient.administrativeGenderCode"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Gender Used"
                    }
                ]
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "short": "The date of birth for the individual",
                "definition": "The date of birth for the individual.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "requirements": "Age of the individual drives many clinical processes.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.birthDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "date"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-7"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"
                    },
                    {
                        "identity": "cda",
                        "map": ".patient.birthTime"
                    },
                    {
                        "identity": "loinc",
                        "map": "21112-8"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Birth Date"
                    }
                ]
            },
            {
                "id": "Patient.birthDate.id",
                "path": "Patient.birthDate.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references)",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.birthDate.extension",
                "path": "Patient.birthDate.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "May 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.birthDate.extension:birthTime",
                "path": "Patient.birthDate.extension",
                "sliceName": "birthTime",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-birthTime"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.birthDate.value",
                "path": "Patient.birthDate.value",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Primitive value for date",
                "definition": "The actual value",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "date.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "date"
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/regex",
                                "valueString": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.Date"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Patient.deceased[x]",
                "path": "Patient.deceased[x]",
                "short": "Indicates if the individual is deceased or not",
                "definition": "Indicates if the individual is deceased or not.",
                "comment": "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.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.deceased[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-30  (bool) and PID-29 (datetime)"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Death"
                    }
                ]
            },
            {
                "id": "Patient.address",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Patient.address",
                "short": "An address expressed using postal conventions (as opposed to GPS or other location definition formats)",
                "definition": "An address expressed using postal conventions (as opposed to GPS or other location definition formats).  This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery.  There are a variety of postal address formats defined around the world.",
                "comment": "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](location.html#) resource).",
                "requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.address",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Address",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/address-ca-core"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-11"
                    },
                    {
                        "identity": "rim",
                        "map": "addr"
                    },
                    {
                        "identity": "cda",
                        "map": ".addr"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "XAD"
                    },
                    {
                        "identity": "rim",
                        "map": "AD"
                    },
                    {
                        "identity": "servd",
                        "map": "Address"
                    }
                ]
            },
            {
                "id": "Patient.address.id",
                "path": "Patient.address.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.address.extension",
                "path": "Patient.address.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.address.use",
                "path": "Patient.address.use",
                "short": "home | work | temp | old | billing - purpose of this address",
                "definition": "The purpose of this address.",
                "comment": "Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
                "requirements": "Allows an appropriate address to be chosen from a list of many.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueCode": "home"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AddressUse"
                        }
                    ],
                    "strength": "required",
                    "description": "The use of an address.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/address-use|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.7"
                    },
                    {
                        "identity": "rim",
                        "map": "unique(./use)"
                    },
                    {
                        "identity": "servd",
                        "map": "./AddressPurpose"
                    }
                ]
            },
            {
                "id": "Patient.address.type",
                "path": "Patient.address.type",
                "short": "postal | physical | both",
                "definition": "Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.",
                "comment": "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](location.html#) resource).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueCode": "both"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AddressType"
                        }
                    ],
                    "strength": "required",
                    "description": "The type of an address (physical / postal).",
                    "valueSet": "http://hl7.org/fhir/ValueSet/address-type|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.18"
                    },
                    {
                        "identity": "rim",
                        "map": "unique(./use)"
                    },
                    {
                        "identity": "vcard",
                        "map": "address type parameter"
                    }
                ]
            },
            {
                "id": "Patient.address.text",
                "path": "Patient.address.text",
                "short": "Text representation of the address",
                "definition": "Specifies 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.",
                "comment": "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.",
                "requirements": "A renderable, unencoded form.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "137 Nowhere Street, Erewhon 9132"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6"
                    },
                    {
                        "identity": "rim",
                        "map": "./formatted"
                    },
                    {
                        "identity": "vcard",
                        "map": "address label parameter"
                    }
                ]
            },
            {
                "id": "Patient.address.line",
                "path": "Patient.address.line",
                "short": "Street name, number, direction & P.O. Box etc.",
                "definition": "This component contains the house number, apartment number, street name, street direction,  P.O. Box number, delivery hints, and similar address information.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Address.line",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "orderMeaning": "The order in which lines should appear in an address label",
                "example":  [
                    {
                        "label": "General",
                        "valueString": "137 Nowhere Street"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = AL]"
                    },
                    {
                        "identity": "vcard",
                        "map": "street"
                    },
                    {
                        "identity": "servd",
                        "map": "./StreetAddress (newline delimitted)"
                    }
                ]
            },
            {
                "id": "Patient.address.city",
                "path": "Patient.address.city",
                "short": "Name of city, town etc.",
                "definition": "The name of the city, town, suburb, village or other community or delivery center.",
                "alias":  [
                    "Municpality"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.city",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "Erewhon"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.3"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = CTY]"
                    },
                    {
                        "identity": "vcard",
                        "map": "locality"
                    },
                    {
                        "identity": "servd",
                        "map": "./Jurisdiction"
                    }
                ]
            },
            {
                "id": "Patient.address.district",
                "path": "Patient.address.district",
                "short": "District name (aka county)",
                "definition": "The name of the administrative area (county).",
                "comment": "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.",
                "alias":  [
                    "County"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.district",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "Madison"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.9"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = CNT | CPA]"
                    }
                ]
            },
            {
                "id": "Patient.address.state",
                "path": "Patient.address.state",
                "short": "The Province or Territory of Canada, or Province, Territory of State of another country",
                "definition": "The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA",
                "alias":  [
                    "Province",
                    "Territory"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.state",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.4"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = STA]"
                    },
                    {
                        "identity": "vcard",
                        "map": "region"
                    },
                    {
                        "identity": "servd",
                        "map": "./Region"
                    }
                ]
            },
            {
                "id": "Patient.address.postalCode",
                "path": "Patient.address.postalCode",
                "short": "Postal code for area",
                "definition": "A postal code designating a region defined by the postal service.",
                "alias":  [
                    "Zip"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.postalCode",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "9132"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.5"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = ZIP]"
                    },
                    {
                        "identity": "vcard",
                        "map": "code"
                    },
                    {
                        "identity": "servd",
                        "map": "./PostalIdentificationCode"
                    }
                ]
            },
            {
                "id": "Patient.address.country",
                "path": "Patient.address.country",
                "short": "Recommend use of the HL7 Country ValueSet 3 letter code",
                "definition": "Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html",
                "comment": "ISO 3166 3 letter codes can be used in place of a human readable country name.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.country",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.6"
                    },
                    {
                        "identity": "rim",
                        "map": "AD.part[parttype = CNT]"
                    },
                    {
                        "identity": "vcard",
                        "map": "country"
                    },
                    {
                        "identity": "servd",
                        "map": "./Country"
                    }
                ]
            },
            {
                "id": "Patient.address.period",
                "path": "Patient.address.period",
                "short": "Time period when address was/is in use",
                "definition": "Time period when address was/is in use.",
                "requirements": "Allows addresses to be placed in historical context.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Address.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valuePeriod": {
                            "start": "2010-03-23",
                            "end": "2010-07-01"
                        }
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "XAD.12 / XAD.13 + XAD.14"
                    },
                    {
                        "identity": "rim",
                        "map": "./usablePeriod[type=\"IVL<TS>\"]"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "Patient.maritalStatus",
                "path": "Patient.maritalStatus",
                "short": "Marital (civil) status of a patient",
                "definition": "This field contains a patient's most recent marital (civil) status.",
                "requirements": "Most, if not all systems capture it.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.maritalStatus",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MaritalStatus"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "The domestic partnership status of a person.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/marital-status"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-16"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN]/maritalStatusCode"
                    },
                    {
                        "identity": "cda",
                        "map": ".patient.maritalStatusCode"
                    }
                ]
            },
            {
                "id": "Patient.multipleBirth[x]",
                "path": "Patient.multipleBirth[x]",
                "short": "Whether patient is part of a multiple birth",
                "definition": "Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).",
                "comment": "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).",
                "requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.multipleBirth[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "integer"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-24 (bool), PID-25 (integer)"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.photo",
                "path": "Patient.photo",
                "short": "Image of the patient",
                "definition": "Image of the patient.",
                "comment": "Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates.",
                "requirements": "Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.photo",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Attachment"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5 - needs a profile"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
                        "valueString": "Contact"
                    }
                ],
                "path": "Patient.contact",
                "short": "A contact party (e.g. guardian, partner, friend) for the patient",
                "definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
                "comment": "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.",
                "requirements": "Need to track people you can contact about the patient.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.contact",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "pat-1",
                        "severity": "error",
                        "human": "SHALL at least contain a contact's details or a reference to an organization",
                        "expression": "name.exists() or telecom.exists() or address.exists() or organization.exists()",
                        "xpath": "exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.id",
                "path": "Patient.contact.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.extension",
                "path": "Patient.contact.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.modifierExtension",
                "path": "Patient.contact.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "May 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.contact.relationship",
                "path": "Patient.contact.relationship",
                "short": "The kind of relationship",
                "definition": "The nature of the relationship between the patient and the contact person.",
                "requirements": "Used to determine which contact person is the most relevant to approach, depending on circumstances.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.contact.relationship",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ContactRelationship"
                        }
                    ],
                    "strength": "extensible",
                    "description": "The nature of the relationship between a patient and a contact person for that patient.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/patient-contactrelationship"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-7, NK1-3"
                    },
                    {
                        "identity": "rim",
                        "map": "code"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.name",
                "path": "Patient.contact.name",
                "short": "A name associated with the contact person",
                "definition": "A name associated with the contact person.",
                "requirements": "Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.contact.name",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "HumanName"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-2"
                    },
                    {
                        "identity": "rim",
                        "map": "name"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.telecom",
                "path": "Patient.contact.telecom",
                "short": "A contact detail for the person",
                "definition": "A contact detail for the person, e.g. a telephone number or an email address.",
                "comment": "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.",
                "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.contact.telecom",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "ContactPoint"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-5, NK1-6, NK1-40"
                    },
                    {
                        "identity": "rim",
                        "map": "telecom"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.address",
                "path": "Patient.contact.address",
                "short": "Address for the contact person",
                "definition": "Address for the contact person.",
                "requirements": "Need to keep track where the contact person can be contacted per postal mail or visited.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.contact.address",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Address"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-4"
                    },
                    {
                        "identity": "rim",
                        "map": "addr"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.gender",
                "path": "Patient.contact.gender",
                "short": "male | female | other | unknown",
                "definition": "Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.",
                "requirements": "Needed to address the person correctly.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.contact.gender",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AdministrativeGender"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "required",
                    "description": "The gender of a person used for administrative purposes.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-15"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.organization",
                "path": "Patient.contact.organization",
                "short": "Organization that is associated with the contact",
                "definition": "Organization on behalf of which the contact is acting or for which the contact is working.",
                "requirements": "For guardians or business related contacts, the organization is relevant.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.contact.organization",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "condition":  [
                    "pat-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"
                    },
                    {
                        "identity": "rim",
                        "map": "scoper"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.contact.period",
                "path": "Patient.contact.period",
                "short": "The period during which this contact person or organization is valid to be contacted relating to this patient",
                "definition": "The period during which this contact person or organization is valid to be contacted relating to this patient.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.contact.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "effectiveTime"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication",
                "path": "Patient.communication",
                "short": "A language which may be used to communicate with the patient about his or her health",
                "definition": "A language which may be used to communicate with the patient about his or her health.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.communication",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "LanguageCommunication"
                    },
                    {
                        "identity": "cda",
                        "map": "patient.languageCommunication"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Service Language"
                    }
                ]
            },
            {
                "id": "Patient.communication.id",
                "path": "Patient.communication.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.extension",
                "path": "Patient.communication.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.modifierExtension",
                "path": "Patient.communication.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "May 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.communication.language",
                "path": "Patient.communication.language",
                "short": "The language which can be used to communicate with the patient about his or her health",
                "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
                "comment": "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.",
                "requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Patient.communication.language",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-15, LAN-2"
                    },
                    {
                        "identity": "rim",
                        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"
                    },
                    {
                        "identity": "cda",
                        "map": ".languageCode"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.id",
                "path": "Patient.communication.language.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.extension",
                "path": "Patient.communication.language.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding",
                "path": "Patient.communication.language.coding",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
                "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.id",
                "path": "Patient.communication.language.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.extension",
                "path": "Patient.communication.language.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.system",
                "path": "Patient.communication.language.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "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.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.version",
                "path": "Patient.communication.language.coding.version",
                "short": "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.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.code",
                "path": "Patient.communication.language.coding.code",
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Service Language Code"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Patient.communication.language.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.userSelected",
                "path": "Patient.communication.language.coding.userSelected",
                "short": "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).",
                "comment": "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.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "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   ]"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Patient.communication.language.text",
                "short": "Plain text representation of the concept",
                "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "Patient.communication.preferred",
                "path": "Patient.communication.preferred",
                "short": "Language preference indicator",
                "definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
                "comment": "This language is specifically identified for communicating healthcare information.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.communication.preferred",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-15"
                    },
                    {
                        "identity": "rim",
                        "map": "preferenceInd"
                    },
                    {
                        "identity": "cda",
                        "map": ".preferenceInd"
                    }
                ]
            },
            {
                "id": "Patient.generalPractitioner",
                "path": "Patient.generalPractitioner",
                "short": "Patient's nominated primary care provider",
                "definition": "Patient's nominated care provider.",
                "comment": "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.\nMultiple 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.\n\nJurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.",
                "alias":  [
                    "careProvider"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.generalPractitioner",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PD1-4"
                    },
                    {
                        "identity": "rim",
                        "map": "subjectOf.CareEvent.performer.AssignedEntity"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.managingOrganization",
                "path": "Patient.managingOrganization",
                "short": "Organization that is the custodian of the patient record",
                "definition": "Organization that is the custodian of the patient record.",
                "comment": "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).",
                "requirements": "Need to know who recognizes this patient record, manages and updates it.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Patient.managingOrganization",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "scoper"
                    },
                    {
                        "identity": "cda",
                        "map": ".providerOrganization"
                    }
                ]
            },
            {
                "id": "Patient.link",
                "path": "Patient.link",
                "short": "Link to another patient resource that concerns the same actual person",
                "definition": "Link to another patient resource that concerns the same actual patient.",
                "comment": "There is no assumption that linked patient records have mutual links.",
                "requirements": "There are multiple use cases:   \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Patient.link",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "outboundLink"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.link.id",
                "path": "Patient.link.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.link.extension",
                "path": "Patient.link.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.link.modifierExtension",
                "path": "Patient.link.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "May 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Patient.link.other",
                "path": "Patient.link.other",
                "short": "The other patient or related person resource that the link refers to",
                "definition": "The other patient resource that the link refers to.",
                "comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Patient.link.other",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy",
                                "valueBoolean": false
                            }
                        ],
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "PID-3, MRG-1"
                    },
                    {
                        "identity": "rim",
                        "map": "id"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Patient.link.type",
                "path": "Patient.link.type",
                "short": "replaced-by | replaces | refer | seealso",
                "definition": "The type of link between this patient resource and another patient resource.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Patient.link.type",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "LinkType"
                        }
                    ],
                    "strength": "required",
                    "description": "The type of link between this patient resource and another patient resource.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/link-type|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "typeCode"
                    },
                    {
                        "identity": "cda",
                        "map": "n/a"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "Patient",
                "path": "Patient",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person*",
                        "comment": "*In the context of a person in a Party Role of Patient"
                    }
                ]
            },
            {
                "id": "Patient.extension",
                "path": "Patient.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "Patient.extension:indigenousIdentity",
                "path": "Patient.extension",
                "sliceName": "indigenousIdentity",
                "short": "Extension for representing a code classifying a person's indigenous identity.",
                "definition": "A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/indigenous-identity-ca-core"
                        ]
                    }
                ],
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Indigenous Identity"
                    }
                ]
            },
            {
                "id": "Patient.extension:racializedGroup",
                "path": "Patient.extension",
                "sliceName": "racializedGroup",
                "short": "Extension for representing a code classifying a person's racialized group.",
                "definition": "A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/racialized-group-ca-core"
                        ]
                    }
                ],
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Racialized Group"
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender",
                "path": "Patient.extension",
                "sliceName": "recordedSexOrGender",
                "short": "Recorded sex or gender (RSG) information includes the various sex and gender concepts.",
                "definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value",
                "path": "Patient.extension.extension",
                "sliceName": "value"
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:value.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgender"
                }
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type",
                "path": "Patient.extension.extension",
                "sliceName": "type"
            },
            {
                "id": "Patient.extension:recordedSexOrGender.extension:type.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://loinc.org",
                            "code": "99502-7",
                            "display": "Recorded sex or gender"
                        }
                    ]
                },
                "binding": {
                    "strength": "required",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype"
                }
            },
            {
                "id": "Patient.extension:genderIdentity",
                "path": "Patient.extension",
                "sliceName": "genderIdentity",
                "short": "Extension for representing how the person prefers to self-describe.",
                "definition": "A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity"
                        ]
                    }
                ],
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Gender Identity"
                    }
                ]
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value",
                "path": "Patient.extension.extension",
                "sliceName": "value"
            },
            {
                "id": "Patient.extension:genderIdentity.extension:value.value[x]",
                "path": "Patient.extension.extension.value[x]",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode"
                }
            },
            {
                "id": "Patient.extension:pronouns",
                "path": "Patient.extension",
                "sliceName": "pronouns",
                "short": "Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)",
                "definition": "A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/individual-pronouns-ca-core"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:birthsex",
                "path": "Patient.extension",
                "sliceName": "birthsex",
                "short": "A code that specifies the sex of a person at birth which is a clinical finding",
                "definition": "A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.extension:CommunicationBarrier",
                "path": "Patient.extension",
                "sliceName": "CommunicationBarrier",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/ext-communicationbarrier"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "type"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "requirements": "Patients are generally assigned specific alphanumeric identifiers.",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier"
                    }
                ]
            },
            {
                "id": "Patient.identifier.type",
                "path": "Patient.identifier.type",
                "min": 1,
                "example":  [
                    {
                        "label": "Jurisdictional Health Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "JHN"
                                }
                            ]
                        }
                    },
                    {
                        "label": "Medical Record Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MR"
                                }
                            ]
                        }
                    },
                    {
                        "label": "Passport Number",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "PPN"
                                }
                            ]
                        }
                    },
                    {
                        "label": "National Unique Identifier (Placeholder Concept)",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "NH"
                                }
                            ]
                        }
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Type Code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier Type Code"
                    }
                ]
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier System"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "*Issued By",
                        "comment": "*Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner"
                    }
                ]
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Non-Health Identifier"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.start",
                "path": "Patient.identifier.period.start",
                "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Effective Date"
                    }
                ]
            },
            {
                "id": "Patient.identifier.period.end",
                "path": "Patient.identifier.period.end",
                "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Health Identifier Expiry Date"
                    }
                ]
            },
            {
                "id": "Patient.identifier.assigner",
                "path": "Patient.identifier.assigner",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Issued By",
                        "comment": "Many FHIR implementers omit the assigner element if the identifier.system is uniquely tied to a single assigning organization/program. Identifiers that can not be uniquely identified against an assigner using system are expected to convey assigner in identifier.assigner"
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN",
                "path": "Patient.identifier",
                "sliceName": "JHN",
                "short": "Jurisdictional Health Number",
                "definition": "Patient and person health numbers used by all jurisdictions across Canada",
                "min": 0,
                "max": "*"
            },
            {
                "id": "Patient.identifier:JHN.extension:versionCode",
                "path": "Patient.identifier.extension",
                "sliceName": "versionCode",
                "short": "Health Number Version Code",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.type",
                "path": "Patient.identifier.type",
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "JHN",
                            "display": "Jurisdictional Health Number"
                        }
                    ]
                },
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN.system",
                "path": "Patient.identifier.system",
                "short": "A Health Number Naming System from the Canadian URI Registry",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN.value",
                "path": "Patient.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN",
                "path": "Patient.identifier",
                "sliceName": "MRN",
                "short": "Medical Record Number",
                "definition": "A local patient identifier from the submitting PoS System",
                "comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
                "min": 0,
                "max": "*"
            },
            {
                "id": "Patient.identifier:MRN.type",
                "path": "Patient.identifier.type",
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "MR",
                            "display": "Medical Record Number"
                        }
                    ]
                },
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN.system",
                "path": "Patient.identifier.system",
                "short": "An identifier for the system supplying the MRN",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN.value",
                "path": "Patient.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Patient.active",
                "path": "Patient.active",
                "comment": "it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients"
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
                "min": 1,
                "constraint":  [
                    {
                        "key": "ca-core-pat-1",
                        "severity": "error",
                        "human": "Either Patient.name.given and/or Patient.name.family SHALL be present.",
                        "expression": "(family.exists() or given.exists())",
                        "xpath": "(/f:name/f:family or /f:name/f:given)",
                        "source": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name"
                    }
                ]
            },
            {
                "id": "Patient.name.use",
                "path": "Patient.name.use",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Type Code"
                    }
                ]
            },
            {
                "id": "Patient.name.text",
                "path": "Patient.name.text",
                "definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
                "comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance"
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Surname"
                    }
                ]
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "orderMeaning": "Patient.name.given[0] is expected to be the first name in a sequence. Patient.name.given[i], where i>0, is expected to express a Patient's middle name(s)",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Given Name"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Middle Name"
                    }
                ]
            },
            {
                "id": "Patient.name.period.start",
                "path": "Patient.name.period.start",
                "comment": "This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Effective Date"
                    }
                ]
            },
            {
                "id": "Patient.name.period.end",
                "path": "Patient.name.period.end",
                "comment": "This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Name Expiry Date"
                    }
                ]
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Contact Mechanism"
                    }
                ]
            },
            {
                "id": "Patient.telecom.system",
                "path": "Patient.telecom.system",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.value",
                "path": "Patient.telecom.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.use",
                "path": "Patient.telecom.use",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.period.end",
                "path": "Patient.telecom.period.end",
                "mustSupport": true
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "short": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.",
                "definition": "The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Gender Used"
                    }
                ]
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Birth Date"
                    }
                ]
            },
            {
                "id": "Patient.birthDate.extension",
                "path": "Patient.birthDate.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "Patient.birthDate.extension:birthTime",
                "path": "Patient.birthDate.extension",
                "sliceName": "birthTime",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient-birthTime"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.deceased[x]",
                "path": "Patient.deceased[x]",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Person Death"
                    }
                ]
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "type":  [
                    {
                        "code": "Address",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/address-ca-core"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.address.line",
                "path": "Patient.address.line",
                "mustSupport": true
            },
            {
                "id": "Patient.address.city",
                "path": "Patient.address.city",
                "mustSupport": true
            },
            {
                "id": "Patient.address.postalCode",
                "path": "Patient.address.postalCode",
                "mustSupport": true
            },
            {
                "id": "Patient.address.country",
                "path": "Patient.address.country",
                "mustSupport": true
            },
            {
                "id": "Patient.communication",
                "path": "Patient.communication",
                "comment": "This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Service Language"
                    }
                ]
            },
            {
                "id": "Patient.communication.language.coding.code",
                "path": "Patient.communication.language.coding.code",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Party Service Language Code"
                    }
                ]
            },
            {
                "id": "Patient.generalPractitioner",
                "path": "Patient.generalPractitioner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.managingOrganization",
                "path": "Patient.managingOrganization",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ]
            }
        ]
    }
}

Terminology bindings

Path	Conformance	ValueSet
Patient.extension:recordedSexOrGender.extension:value.value[x]	extensible	https://fhir.infoway-inforoute.ca/ValueSet/recordedgender
Patient.extension:recordedSexOrGender.extension:type.value[x]	required	https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype
Patient.extension:genderIdentity.extension:value.value[x]	extensible	https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode

Constraints

Path	Id	Grade	Details	Expression
Patient.name	ca-core-pat-1	error	Either Patient.name.given and/or Patient.name.family SHALL be present.	(family.exists() or given.exists())

Patient (CA-Core)

Links

Profile

Derived from

Examples

Description

References to this resource

Resource Content

Terminology bindings

Constraints