Ontario Patient Summary HL7© FHIR© Implementation Guide

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)

Formal Views of Profile Content

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

Hybrid View

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-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` pson-pat-1:Patient.identifier:JHN or Patient.identifier:MRN or both SHALL be present `identifier.where(type.coding.code = 'JHN').exists() or identifier.where(type.coding.code = 'MR').exists()` Mappings rim:Entity. Role, or Act rim:Patient[classCode=PAT] cda:ClinicalDocument.recordTarget.patientRole
meta	S Σ	1..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())` Mappings rim:n/a rim:N/A
versionId	Σ	0..1	id	There are no (further) constraints on this element Element Id Patient.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data Type id Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element Id Patient.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data Type instant Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
source	Σ	0..1	uri	There are no (further) constraints on this element Element Id Patient.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
profile	S Σ	1..*	canonical(StructureDefinition)	There are no (further) constraints on this element Element Id Patient.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It 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. Data Type canonical(StructureDefinition) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Patient.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element Id Patient.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data Type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
identifier	S Σ	1..*	Identifier DataType Profile (CA Baseline)	Element Id Patient.identifier Short description An identifier intended for computation Definition An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. Requirements Patients are almost always assigned specific numerical identifiers. Comments This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type. Data Type Identifier DataType Profile (CA Baseline) 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 rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:PID-3 rim:id cda:.id
(All Slices)				There are no (further) constraints on this element
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 rim:n/a v2:N/A rim:Role.code or implied by context
type	Σ	0..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 Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	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 rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	1..1	string	Element Id Patient.identifier.value Short description The value that is unique within the system. 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 rim:n/a v2:CX.1 / EI.1 rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd:./Value
period	Σ I	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ I	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())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:CX.4 / (CX.4,CX.9,CX.10) rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd:./IdentifierIssuingAuthority
JHN	S Σ	0..*	Identifier	Element Id Patient.identifier:JHN Short description Jurisdictional Health Number Definition Federal patient and person health numbers used by all jurisdictions across Canada Requirements Patients are almost always assigned specific numerical identifiers. Comments MS applied in PS-ON Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:PID-3 rim:id cda:.id
extension	I	0..*	Extension	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) 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
versionCode	I	0..1	Extension(string)	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(string) 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 rim:n/a v2:N/A rim:Role.code or implied by context
type	Σ	1..1	CodeableConceptBindingFixed Value	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())` Fixed Value { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	Σ	1..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 rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	1..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 rim:n/a v2:CX.1 / EI.1 rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd:./Value
period	Σ I	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ I	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())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:CX.4 / (CX.4,CX.9,CX.10) rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd:./IdentifierIssuingAuthority
MRN	S 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. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:PID-3 rim:id cda:.id
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 rim:n/a v2:N/A rim:Role.code or implied by context
type	Σ	1..1	CodeableConceptBindingFixed Value	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())` Fixed Value { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	Σ	1..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 rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	1..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 rim:n/a v2:CX.1 / EI.1 rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd:./Value
period	Σ I	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ I	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())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:CX.4 / (CX.4,CX.9,CX.10) rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd:./IdentifierIssuingAuthority
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 If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. 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 rim:n/a 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())` cabaseline-pat-1:Patient.name.given or Patient.name.family or both SHALL be present `family.exists() or given.exists()` Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:PID-5, PID-9 rim:name cda:.patient.name
use	Σ ?!	0..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 rim:n/a v2:XPN.7, but often indicated by which field contains the name rim:unique(./use) servd:./NamePurpose
text	S 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 rim:n/a 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 rim:n/a v2:XPN.1/FN.1 rim:./part[partType = FAM] servd:./FamilyName
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 rim:n/a v2:XPN.2 + XPN.3 rim:./part[partType = GIV] servd:./GivenNames
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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN/4 rim:./part[partType = SFX]
period	Σ I	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XPN.13 + XPN.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate
telecom	S Σ I	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())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:PID-13, PID-14, PID-40 rim:telecom cda:.telecom
gender	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. 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 rim:n/a v2:PID-8 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda:.patient.administrativeGenderCode
birthDate	S Σ	1..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 At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). Data Type date Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:PID-7 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda:.patient.birthTime loinc:21112-8
deceased[x]	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 rim:n/a v2:PID-30 (bool) and PID-29 (datetime) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda:n/a
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 I	0..*	Address	Element Id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Patient may have multiple addresses with different uses or applicable periods. Data Type Address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` pat-cnt-2or3-char: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. `country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3'))` Mappings rim:n/a v2:XAD rim:AD servd:Address v2:PID-11 rim:addr cda:.addr
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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. 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 rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-16 rim:player[classCode=PSN]/maritalStatusCode cda:.patient.maritalStatusCode
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 rim:n/a v2:PID-24 (bool), PID-25 (integer) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda:n/a
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	I	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())` att-1:If the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim:n/a v2:ED/RP rim:ED v2:OBX-5 - needs a profile rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda:n/a
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:n/a rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda:n/a
relationship		0..*	Codeable Concept (PS-ON)Binding	Element Id Patient.contact.relationship Short description Concept - reference to a terminology or just text Definition A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. Data Type Codeable Concept (PS-ON) 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 rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:NK1-7, NK1-3 rim:code cda:n/a
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. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. Data Type HumanName Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:NK1-2 rim:name cda:n/a
telecom	I	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())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:NK1-5, NK1-6, NK1-40 rim:telecom cda:n/a
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. 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 Address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:XAD rim:AD servd:Address v2:NK1-4 rim:addr cda:n/a
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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 rim:n/a 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. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim:scoper cda:n/a
period	I	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. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim:effectiveTime cda:n/a
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 If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:LanguageCommunication cda:patient.languageCommunication
language		1..1	CodeableConceptBinding	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. AllLanguages (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-15, LAN-2 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda:.languageCode
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 rim:n/a v2:PID-15 rim:preferenceInd cda:.preferenceInd
generalPractitioner	S I	0..*	Reference(Organization \| Practitioner \| PractitionerRole)	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(Organization \| Practitioner \| PractitionerRole) Sliced: Unordered, Open, by resolve()(Profile) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PD1-4 rim:subjectOf.CareEvent.performer.AssignedEntity cda:n/a
PractitionerRolePSON	S I	0..*	Reference(PractitionerRole (PS-ON))	Element Id Patient.generalPractitioner:PractitionerRolePSON 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(PractitionerRole (PS-ON)) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PD1-4 rim:subjectOf.CareEvent.performer.AssignedEntity cda:n/a
managingOrganization	Σ I	0..1	Reference(Organization)	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(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:scoper cda:.providerOrganization
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:n/a rim:outboundLink cda:n/a
other	Σ I	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())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PID-3, MRG-1 rim:id cda:n/a
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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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:n/a rim:typeCode cda:n/a

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "ca-on-ps-profile-patient",
    "url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient",
    "version": "0.10.0",
    "name": "PatientPSON",
    "title": "Patient (PS-ON)",
    "status": "draft",
    "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",
                "path": "Patient.identifier.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "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.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,
                "max": "*",
                "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.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:PractitionerRolePSON",
                "path": "Patient.generalPractitioner",
                "sliceName": "PractitionerRolePSON",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole"
                        ]
                    }
                ],
                "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|0.9.1

.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) profile. Other references may be sent as well, as long as at least one PractitionerRole (PS-ON) is included

Profile: Patient

Formal Views of Profile Content

Differential View

Hybrid View

Snapshot View

Table View

JSON View

Usage

Notes

Patient		..
Patient.meta		1..
Patient.meta.profile		1..
Patient.identifier	Identifier DataType Profile (CA Baseline)	1..
Patient.identifier.type		..
Patient.identifier.system		1..
Patient.identifier.value		1..
Patient.identifier		..
Patient.identifier.extension		..
Patient.identifier.extension	Extension	..
Patient.identifier.type		1..
Patient.identifier.system		1..
Patient.identifier.value		1..
Patient.identifier		..
Patient.identifier.type		1..
Patient.identifier.system		1..
Patient.identifier.value		1..
Patient.name		1..*
Patient.name.text		..
Patient.name.family		..
Patient.name.given		..
Patient.telecom		..
Patient.gender		1..
Patient.birthDate		1..
Patient.address		..
Patient.contact		..
Patient.contact.relationship	Codeable Concept (PS-ON)	..
Patient.communication		..
Patient.communication.language		..
Patient.generalPractitioner		..
Patient.generalPractitioner	Reference(PractitionerRole (PS-ON))	..