Profiles & Transactions > Patient Profile

Structure Definition: Patient Profile

Canonical URL:http://ehealthontario.on.ca/fhir/StructureDefinition/ca-on-cms-profile-Patient

Simplifier project page: CMSPatient

Derived from: Patient (R4)

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Differential View

idΣ0..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
id0..1string
data-absent-reasonS I0..1Extension(stringurl)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
givenS Σ0..*string
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
id0..1string
extensionI0..*Extension
systemS Σ I1..1codeBinding
valueS Σ1..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
id0..1string
extensionI0..*Extension
useS Σ ?!0..1codeBinding
typeS Σ0..1codeBinding
textΣ0..1string
lineS Σ0..*string
cityS Σ0..1string
districtΣ0..1string
stateS Σ0..1string
postalCodeS Σ0..1string
countryS Σ0..1string
periodΣ I0..1Period
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding
}

Hybrid View

idΣ0..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
id0..1string
data-absent-reasonS I0..1Extension(stringurl)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
givenS Σ0..*string
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
id0..1string
extensionI0..*Extension
systemS Σ I1..1codeBinding
valueS Σ1..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
id0..1string
extensionI0..*Extension
useS Σ ?!0..1codeBinding
typeS Σ0..1codeBinding
textΣ0..1string
lineS Σ0..*string
cityS Σ0..1string
districtΣ0..1string
stateS Σ0..1string
postalCodeS Σ0..1string
countryS Σ0..1string
periodΣ I0..1Period
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding

Snapshot View

idΣ0..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
id0..1string
data-absent-reasonS I0..1Extension(stringurl)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
givenS Σ0..*string
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
id0..1string
extensionI0..*Extension
systemS Σ I1..1codeBinding
valueS Σ1..1string
useΣ ?!0..1codeBinding
rankΣ0..1positiveInt
periodΣ I0..1Period
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
id0..1string
extensionI0..*Extension
useS Σ ?!0..1codeBinding
typeS Σ0..1codeBinding
textΣ0..1string
lineS Σ0..*string
cityS Σ0..1string
districtΣ0..1string
stateS Σ0..1string
postalCodeS Σ0..1string
countryS Σ0..1string
periodΣ I0..1Period
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding

Table View

Patient..
Patient.meta1..
Patient.meta.profile1..
Patient.identifier1..
Patient.identifier.extensionExtension..
Patient.identifier.system..
Patient.identifier.value..
Patient.name1..
Patient.name.text..
Patient.name.family..
Patient.name.given..
Patient.telecom..
Patient.telecom.system1..
Patient.telecom.value1..
Patient.gender1..
Patient.birthDate1..
Patient.deceased[x]..
Patient.address..
Patient.address.use..
Patient.address.type..
Patient.address.line..
Patient.address.city..
Patient.address.state..
Patient.address.postalCode..
Patient.address.country..
Patient.photo..

JSON View

{
    "resourceType": "StructureDefinition",
    "text": {
        "status": "empty",
        --- We have skipped the narrative for better readability of the resource ---
    },
    "url": "http://ehealthontario.on.ca/fhir/StructureDefinition/ca-on-cms-profile-Patient",
    "version": "1.0.0",
    "name": "CMSPatient",
    "status": "draft",
    "description": "The elements marked as MustSupport ('S' in a red box) must be supported if the data is present in the sending system. Please <a href= \"https://www.hl7.org/fhir/conformance-rules.html#mustSupport\" target=\"blank\">click here </a> for the details.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient.meta",
                "path": "Patient.meta",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.meta.profile",
                "path": "Patient.meta.profile",
                "comment": "#### **_` FOR CMS USAGE: The meta.profile = http://ehealthontario.ca/fhir/StructureDefinition/ca-on-cms-profile-Patient|1.0.0 `_**\nIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "comment": "#### **_`FOR CMS USAGE: For Patient.identifier, Ontario Health Card Number (HCN) and Medical Record Number (MRN) are supported. In case of Ontario HCN, the identifier.system = \"https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn\". In case of MRN, identifier.system should be the corresponding MRN of the healthcare facility. CMS will reject the request upon receiving multiple Ontario HCNs.`_**",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.extension:data-absent-reason",
                "path": "Patient.identifier.extension",
                "sliceName": "data-absent-reason",
                "definition": "Provides a reason why the expected value or elements in the element that is extended are missing.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "min": 1,
                "constraint":  [
                    {
                        "key": "ele-2",
                        "severity": "error",
                        "human": "SHALL atleast contain a family name or text",
                        "expression": "family.exist() or text.exist()"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.name.text",
                "path": "Patient.name.text",
                "mustSupport": true
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "mustSupport": true
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "definition": "#### **_` FOR CMS USAGE: It is recommended to provide Patient's First Name in the first instance and the Middle Name(s) in the subsequent instances. CMS doesn't impose any limitations on the number of repetitions but recommends to align with Provincial Client Registry. `_**",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.system",
                "path": "Patient.telecom.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.value",
                "path": "Patient.telecom.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.deceased[x]",
                "path": "Patient.deceased[x]",
                "mustSupport": false
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "mustSupport": true
            },
            {
                "id": "Patient.address.use",
                "path": "Patient.address.use",
                "mustSupport": true
            },
            {
                "id": "Patient.address.type",
                "path": "Patient.address.type",
                "mustSupport": true
            },
            {
                "id": "Patient.address.line",
                "path": "Patient.address.line",
                "definition": "This component contains the house number, apartment number, street name, street direction,  P.O. Box number, delivery hints, and similar address information.\n\n#### **_` FOR CMS USAGE: It's recommended to have 4 lines and each line to have a limit of 80 characters. `_**",
                "mustSupport": true
            },
            {
                "id": "Patient.address.city",
                "path": "Patient.address.city",
                "mustSupport": true
            },
            {
                "id": "Patient.address.state",
                "path": "Patient.address.state",
                "mustSupport": true
            },
            {
                "id": "Patient.address.postalCode",
                "path": "Patient.address.postalCode",
                "mustSupport": true
            },
            {
                "id": "Patient.address.country",
                "path": "Patient.address.country",
                "mustSupport": true
            },
            {
                "id": "Patient.photo",
                "path": "Patient.photo",
                "definition": "Image of the patient.\n\n#### **_` FOR CMS USAGE: The default cardinality is retained for this element. However, the current CMS Specification doesn't support any use-case to support photos due to their size and storage restrictions. `_**"
            }
        ]
    }
}

Usage

The Patient Resource is used to share demographics and other administrative information about the individual who is the subject of the ereferral.

Notes

.id

  • used to uniquely identify the resource

.meta.profile

  • used to declare conformance to this profile
  • populate with a fixed value: http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient|1.0.1

.identifier

  • business identifier(s) for the patient, multiple allowed
  • Patient's Health Card Number (HCN) and Medical Record Number (MRN) are supported
  • Health Card Number Version Code is not captured

.name

  • the name of the patient SHALL atleast be populated with .text or .family
  • .name.text captures the name in a single string.
  • .name.family captures the patient's last name
  • .name.given use multiple instances if patient has multiple given names (e.g. first and middle names)