Profiles & Operations Index > Profile: Patient

Profile: Patient

Canonical URL:http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient

Simplifier project page: Patient (PS-ON)

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
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringS1..1string
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..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
telecomS Σ I0..*ContactPoint
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
addressS Σ I0..*Address
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
id0..1string
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueCodecode
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueStringstring
valueMarkdownmarkdown
url1..1uriFixed Value
value0..1System.String
userSelectedΣ0..1boolean
textS Σ0..1string
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerPSONS I0..*Reference(PractitionerRole (PS-ON) | Practitioner (PS-ON) | Organization (PS-ON))
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
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringS1..1string
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..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
telecomS Σ I0..*ContactPoint
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
addressS Σ I0..*Address
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
id0..1string
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueCodecode
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueStringstring
valueMarkdownmarkdown
url1..1uriFixed Value
value0..1System.String
userSelectedΣ0..1boolean
textS Σ0..1string
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerPSONS I0..*Reference(PractitionerRole (PS-ON) | Practitioner (PS-ON) | Organization (PS-ON))
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
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringS1..1string
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..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
telecomS Σ I0..*ContactPoint
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
addressS Σ I0..*Address
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
id0..1string
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueCodecode
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueStringstring
valueMarkdownmarkdown
url1..1uriFixed Value
value0..1System.String
userSelectedΣ0..1boolean
textS Σ0..1string
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerPSONS I0..*Reference(PractitionerRole (PS-ON) | Practitioner (PS-ON) | Organization (PS-ON))
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.identifierIdentifier DataType Profile (CA Baseline)1..
Patient.identifier.type..
Patient.identifier.system1..
Patient.identifier.value1..
Patient.identifier..
Patient.identifier.extensionExtension..
Patient.identifier.extension.url..
Patient.identifier.type1..
Patient.identifier.system1..
Patient.identifier.value1..
Patient.identifier..
Patient.identifier.type1..
Patient.identifier.system1..
Patient.identifier.value1..
Patient.name1..
Patient.name.text..
Patient.name.family..
Patient.name.given..
Patient.telecom..
Patient.gender1..
Patient.birthDate1..
Patient.address..
Patient.contact..
Patient.contact.relationshipCodeable Concept (PS-ON)..
Patient.contact.relationship.coding..
Patient.contact.relationship.coding.display..
Patient.contact.relationship.coding.display.extension..
Patient.contact.relationship.coding.display.extension.url..
Patient.communication..
Patient.communication.language..
Patient.generalPractitioner..
Patient.generalPractitionerReference(PractitionerRole (PS-ON) | Practitioner (PS-ON) | Organization (PS-ON))..

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "ca-on-ps-profile-patient",
    "url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient",
    "version": "0.12.0",
    "name": "PatientPSON",
    "title": "Patient (PS-ON)",
    "status": "active",
    "date": "2022-10-15T12:00:00+00:00",
    "publisher": "Ontario Health",
    "description": "This profile defines a set of constraints to the FHIR Patient resource for use in Ontario Patient Summaries (PS-ON).  It refines constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources. It is informed by the constraints of the [Patient-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Patient-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-patient.html)",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient",
                "path": "Patient",
                "constraint":  [
                    {
                        "key": "pson-pat-1",
                        "severity": "error",
                        "human": "Patient.identifier:JHN or Patient.identifier:MRN or both SHALL be present",
                        "expression": "identifier.where(type.coding.code = 'JHN').exists() or identifier.where(type.coding.code = 'MR').exists()"
                    }
                ]
            },
            {
                "id": "Patient.meta",
                "path": "Patient.meta",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.meta.profile",
                "path": "Patient.meta.profile",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "type"
                        }
                    ],
                    "rules": "open"
                },
                "comment": "This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type.",
                "min": 1,
                "type":  [
                    {
                        "code": "Identifier",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.type",
                "path": "Patient.identifier.type",
                "example":  [
                    {
                        "label": "Pattern",
                        "valueCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MR"
                                }
                            ]
                        }
                    }
                ]
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "min": 1,
                "isModifier": false
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "short": "The value that is unique within the system.",
                "min": 1,
                "isModifier": false
            },
            {
                "id": "Patient.identifier:JHN",
                "path": "Patient.identifier",
                "sliceName": "JHN",
                "short": "Jurisdictional Health Number",
                "definition": "Federal patient and person health numbers used by all jurisdictions across Canada",
                "comment": "**MS applied in PS-ON**",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN.extension:versionCode",
                "path": "Patient.identifier.extension",
                "sliceName": "versionCode",
                "short": "Health Number Version Code",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.extension:versionCode.url",
                "path": "Patient.identifier.extension.url",
                "fixedUri": "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
            },
            {
                "id": "Patient.identifier:JHN.type",
                "path": "Patient.identifier.type",
                "min": 1,
                "fixedCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "JHN"
                        }
                    ]
                }
            },
            {
                "id": "Patient.identifier:JHN.system",
                "path": "Patient.identifier.system",
                "short": "A Health Number Naming System from the Canadian URI Registry",
                "min": 1
            },
            {
                "id": "Patient.identifier:JHN.value",
                "path": "Patient.identifier.value",
                "min": 1
            },
            {
                "id": "Patient.identifier:MRN",
                "path": "Patient.identifier",
                "sliceName": "MRN",
                "short": "Medical Record Number",
                "definition": "A local patient identifier from the submitting PoS System",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN.type",
                "path": "Patient.identifier.type",
                "min": 1,
                "fixedCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "MR"
                        }
                    ]
                }
            },
            {
                "id": "Patient.identifier:MRN.system",
                "path": "Patient.identifier.system",
                "short": "An identifier for the system supplying the MRN",
                "min": 1
            },
            {
                "id": "Patient.identifier:MRN.value",
                "path": "Patient.identifier.value",
                "min": 1
            },
            {
                "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": "cabaseline-pat-1",
                        "severity": "error",
                        "human": "Patient.name.given or Patient.name.family or both SHALL be present",
                        "expression": "family.exists() or given.exists()",
                        "xpath": "f:given or f:family"
                    }
                ],
                "mustSupport": true
            },
            {
                "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",
                "mustSupport": true
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "mustSupport": true
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "mustSupport": true
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "constraint":  [
                    {
                        "key": "pat-cnt-2or3-char",
                        "severity": "warning",
                        "human": "The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2.",
                        "expression": "country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3'))"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.contact.relationship",
                "path": "Patient.contact.relationship",
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.contact.relationship.coding.display.extension:translation",
                "path": "Patient.contact.relationship.coding.display.extension",
                "sliceName": "translation"
            },
            {
                "id": "Patient.contact.relationship.coding.display.extension:translation.url",
                "path": "Patient.contact.relationship.coding.display.extension.url",
                "fixedUri": "translation"
            },
            {
                "id": "Patient.communication.language",
                "path": "Patient.communication.language",
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/ValueSet/all-languages"
                }
            },
            {
                "id": "Patient.generalPractitioner",
                "path": "Patient.generalPractitioner",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "profile",
                            "path": "resolve()"
                        }
                    ],
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "Patient.generalPractitioner:generalPractitionerPSON",
                "path": "Patient.generalPractitioner",
                "sliceName": "generalPractitionerPSON",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole",
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitioner",
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization"
                        ]
                    }
                ],
                "mustSupport": true
            }
        ]
    }
}

Usage

The Patient Resource is used to provide information about the person who is the subject of a Patient Summary in its header.

Notes

.id

  • Definition: Logical id of this artifact
  • used to uniquely identify the resource
  • if a persistent identity for the resource is not available to use when constructing the composition Bundle, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)
  • Where .id is populated with a persistent identifier, consumers SHALL NOT expect to be able to resolve the resource and SHALL always use the version of the resource contained in the Bundle to render the composition.

.meta.profile

  • used to declare conformance to this profile
  • populate with a fixed value: http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient|0.12.0

.meta.versionId

  • SHALL be populated by the Patient Summary Repository server
  • consuming systems can expect this element to be populated when retrieving patient summary instances from the repository
  • source systems do not need to populate this element prior to submission

.identifier

  • business identifier(s) for the patient, multiple allowed
  • SHALL include at least one unique identifier
  • SHOULD include a jurisdictional health card number without a version code in JHN slice
  • MAY include other business identifiers, such as MRN or ECID

.name

  • SHALL contain the patient's full name
  • at least one of family or given is required; some patients may have only one name

.telecom

  • SHOULD contain both a telephone number and email address

.gender

  • SHALL contain the patient's gender for administrative purposes

.birthDate

  • SHALL contain the patient's date of birth

.address

  • SHOULD contain the patient's primary address(es)

.generalPractitioner

  • SHOULD be used to identify the Practitioner(s) that act as the patient's primary care health care practitioner
  • When present, .generalPractitioner.reference SHALL be populated with a reference to a Practitioner resource:
  • When present, .generalPractitioner.display SHOULD be populated with the Practitioner's full name
  • the referenced resource SHALL be included in the message as a Bundle.entry
  • When .generalPractitioner is used, there must be at least one referenced resource that conforms to the PractitionerRole (PS-ON) or Practitioner (PS-ON) or Organization (PS-ON) profile. Other references may be sent as well, as long as at least one PractitionerRole (PS-ON) is included