Notice
- Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
- This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.
Genomics-Patient
The focal resource for recording who a test order and genomic report are for.
It is expected that client's will need to post Patient resources to the central GMS as some demographic information specific to Genomics will not have been captured within other systems such as PDS.
For patients included within PDS, it is expected source systems SHOULD only send genomic specific information not recorded against PDS, e.g. birthSex, genomic specific identifiers and a link to the PDS record, as well as the NHS number identifier. (NOTE: examples provided for patient resources are fully expanded to illustrate how information should be structured but any infomation already recorded by PDS SHOULD NOT be duplicated within the genomic order management services). Querying patient demographic information, will be supported using the search parameters provided by the Genomic Order Management Service, whch will pass through parameters to PDS where demographics are stored against this system. Client systems will then be required to follow the PDS link within the Genomics-Patient record to retrieve the PDS patient.
It is a requirement on source systems that patient NHS numbers are traced and verified with PDS, if the patient is registered with PDS, before creation of patient resources on the Genomic Order Management broker
For patients not included on PDS, e.g. private/overseas patients or fetal records, the requester SHOULD send all information necessary to facilitate testing and interpretation of the request. Where this patient is later registered on PDS, identified through assignment of an NHS number, demographic details SHALL be stripped from the genomic record to avoid data duplication.
Alternatively, systems MAY opt to include pointers to the Patient resource on their local system, though the mechanism preferred by the NHS England Genomics Unit has yet to be decided.
Profile url | FHIR Module | Normative Status |
---|---|---|
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient | UKCore | trial-use |
UKCorePatient (Patient) | I | Patient | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
birthPlace | I | 0..1 | Extension(Address) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueAddress | Address | ||
birthSex | I | 0..1 | Extension(CodeableConcept) |
cadavericDonor | I | 0..1 | Extension(boolean) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueBoolean | boolean | ||
contactPreference | I | 0..1 | Extension(Complex) |
deathNotificationStatus | I | 0..1 | Extension(Complex) |
ethnicCategory | I | 0..1 | Extension(CodeableConcept) |
fetalStatus | I | 0..1 | Extension(code) |
residentialStatus | I | 0..1 | Extension(CodeableConcept) |
patientInterpreterRequired | I | 0..1 | Extension(boolean) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueBoolean | boolean | ||
nhsNumberUnavailableReason | I | 0..1 | Extension(CodeableConcept) |
modifierExtension | ?! I | 0..* | Extension |
identifier | S Σ | 0..* | Identifier |
nhsNumber | Σ | 0..1 | Identifier |
id | 0..1 | string | |
extension | I | 0..* | Extension |
nhsNumberVerificationStatus | I | 0..1 | Extension(CodeableConcept) |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uriFixed Value |
value | Σ | 1..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference(Organization) |
active | S Σ ?! | 0..1 | boolean |
name | S Σ | 0..* | HumanName |
telecom | S Σ I | 0..* | ContactPoint |
id | 0..1 | string | |
extension | I | 0..* | Extension |
system | Σ I | 0..1 | codeBinding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
otherContactSystem | I | 0..1 | Extension(CodeableConcept) |
value | 0..1 | System.String | |
value | Σ | 0..1 | string |
use | Σ ?! | 0..1 | codeBinding |
rank | Σ | 0..1 | positiveInt |
period | Σ I | 0..1 | Period |
gender | S Σ | 0..1 | codeBinding |
birthDate | S Σ | 0..1 | date |
id | 0..1 | string | |
extension | I | 0..* | Extension |
birthTime | I | 0..1 | Extension(dateTime) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueDateTime | dateTime | ||
value | 0..1 | System.Date | |
deceased[x] | Σ ?! | 0..1 | |
deceasedBoolean | boolean | ||
deceasedDateTime | dateTime | ||
address | S Σ | 0..* | Address |
id | 0..1 | string | |
extension | I | 0..* | Extension |
addressKey | I | 0..* | Extension(Complex) |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | codeBinding |
text | Σ | 0..1 | string |
line | Σ | 0..* | string |
city | Σ | 0..1 | string |
district | Σ | 0..1 | string |
state | Σ | 0..1 | string |
postalCode | Σ | 0..1 | string |
country | Σ | 0..1 | string |
period | Σ I | 0..1 | Period |
maritalStatus | 0..1 | CodeableConceptBinding | |
multipleBirth[x] | 0..1 | ||
multipleBirthBoolean | boolean | ||
multipleBirthInteger | integer | ||
photo | I | 0..* | Attachment |
contact | I | 0..* | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
contactRank | I | 0..1 | Extension(positiveInt) |
copyCorrespondenceIndicator | I | 0..1 | Extension(boolean) |
modifierExtension | Σ ?! I | 0..* | Extension |
relationship | 0..* | CodeableConceptBinding | |
name | 0..1 | HumanName | |
telecom | I | 0..* | ContactPoint |
id | 0..1 | string | |
extension | I | 0..* | Extension |
system | Σ I | 0..1 | codeBinding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
otherContactSystem | I | 0..1 | Extension(CodeableConcept) |
value | 0..1 | System.String | |
value | Σ | 0..1 | string |
use | Σ ?! | 0..1 | codeBinding |
rank | Σ | 0..1 | positiveInt |
period | Σ I | 0..1 | Period |
address | 0..1 | Address | |
gender | 0..1 | codeBinding | |
organization | I | 0..1 | Reference(Organization) |
period | I | 0..1 | Period |
communication | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
proficiency | I | 0..1 | Extension(Complex) |
id | 0..1 | string | |
extension | I | 0..* | Extension |
level | I | 0..1 | Extension |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | Binding | |
valueCoding | Coding | ||
type | I | 0..* | Extension |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | Binding | |
valueCoding | Coding | ||
url | 1..1 | uriFixed Value | |
value[x] | 0..0 | ||
modifierExtension | Σ ?! I | 0..* | Extension |
language | 1..1 | CodeableConceptBinding | |
preferred | 0..1 | boolean | |
generalPractitioner | I | 0..* | Reference(Organization | Practitioner | PractitionerRole) |
managingOrganization | S Σ I | 0..1 | Reference(Organization) |
link | Σ ?! | 0..* | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
other | Σ I | 1..1 | Reference(Patient | RelatedPerson) |
type | Σ | 1..1 | codeBinding |
Differential from Patient
UKCorePatient (Patient) | I | Patient | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
birthPlace | I | 0..1 | Extension(Address) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueAddress | Address | ||
birthSex | I | 0..1 | Extension(CodeableConcept) |
cadavericDonor | I | 0..1 | Extension(boolean) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueBoolean | boolean | ||
contactPreference | I | 0..1 | Extension(Complex) |
deathNotificationStatus | I | 0..1 | Extension(Complex) |
ethnicCategory | I | 0..1 | Extension(CodeableConcept) |
fetalStatus | I | 0..1 | Extension(code) |
residentialStatus | I | 0..1 | Extension(CodeableConcept) |
patientInterpreterRequired | I | 0..1 | Extension(boolean) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueBoolean | boolean | ||
nhsNumberUnavailableReason | I | 0..1 | Extension(CodeableConcept) |
modifierExtension | ?! I | 0..* | Extension |
identifier | S Σ | 0..* | Identifier |
nhsNumber | Σ | 0..1 | Identifier |
id | 0..1 | string | |
extension | I | 0..* | Extension |
nhsNumberVerificationStatus | I | 0..1 | Extension(CodeableConcept) |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uriFixed Value |
value | Σ | 1..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference(Organization) |
active | S Σ ?! | 0..1 | boolean |
name | S Σ | 0..* | HumanName |
telecom | S Σ I | 0..* | ContactPoint |
id | 0..1 | string | |
extension | I | 0..* | Extension |
system | Σ I | 0..1 | codeBinding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
otherContactSystem | I | 0..1 | Extension(CodeableConcept) |
value | 0..1 | System.String | |
value | Σ | 0..1 | string |
use | Σ ?! | 0..1 | codeBinding |
rank | Σ | 0..1 | positiveInt |
period | Σ I | 0..1 | Period |
gender | S Σ | 0..1 | codeBinding |
birthDate | S Σ | 0..1 | date |
id | 0..1 | string | |
extension | I | 0..* | Extension |
birthTime | I | 0..1 | Extension(dateTime) |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | ||
valueDateTime | dateTime | ||
value | 0..1 | System.Date | |
deceased[x] | Σ ?! | 0..1 | |
deceasedBoolean | boolean | ||
deceasedDateTime | dateTime | ||
address | S Σ | 0..* | Address |
id | 0..1 | string | |
extension | I | 0..* | Extension |
addressKey | I | 0..* | Extension(Complex) |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | codeBinding |
text | Σ | 0..1 | string |
line | Σ | 0..* | string |
city | Σ | 0..1 | string |
district | Σ | 0..1 | string |
state | Σ | 0..1 | string |
postalCode | Σ | 0..1 | string |
country | Σ | 0..1 | string |
period | Σ I | 0..1 | Period |
maritalStatus | 0..1 | CodeableConceptBinding | |
multipleBirth[x] | 0..1 | ||
multipleBirthBoolean | boolean | ||
multipleBirthInteger | integer | ||
photo | I | 0..* | Attachment |
contact | I | 0..* | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
contactRank | I | 0..1 | Extension(positiveInt) |
copyCorrespondenceIndicator | I | 0..1 | Extension(boolean) |
modifierExtension | Σ ?! I | 0..* | Extension |
relationship | 0..* | CodeableConceptBinding | |
name | 0..1 | HumanName | |
telecom | I | 0..* | ContactPoint |
id | 0..1 | string | |
extension | I | 0..* | Extension |
system | Σ I | 0..1 | codeBinding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
otherContactSystem | I | 0..1 | Extension(CodeableConcept) |
value | 0..1 | System.String | |
value | Σ | 0..1 | string |
use | Σ ?! | 0..1 | codeBinding |
rank | Σ | 0..1 | positiveInt |
period | Σ I | 0..1 | Period |
address | 0..1 | Address | |
gender | 0..1 | codeBinding | |
organization | I | 0..1 | Reference(Organization) |
period | I | 0..1 | Period |
communication | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
proficiency | I | 0..1 | Extension(Complex) |
id | 0..1 | string | |
extension | I | 0..* | Extension |
level | I | 0..1 | Extension |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | Binding | |
valueCoding | Coding | ||
type | I | 0..* | Extension |
id | 0..1 | string | |
extension | I | 0..0 | Extension |
url | 1..1 | uriFixed Value | |
value[x] | 1..1 | Binding | |
valueCoding | Coding | ||
url | 1..1 | uriFixed Value | |
value[x] | 0..0 | ||
modifierExtension | Σ ?! I | 0..* | Extension |
language | 1..1 | CodeableConceptBinding | |
preferred | 0..1 | boolean | |
generalPractitioner | I | 0..* | Reference(Organization | Practitioner | PractitionerRole) |
managingOrganization | S Σ I | 0..1 | Reference(Organization) |
link | Σ ?! | 0..* | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
other | Σ I | 1..1 | Reference(Patient | RelatedPerson) |
type | Σ | 1..1 | codeBinding |
Patient | |
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. |
Cardinality | 0...* |
Alias | SubjectOfCare Client Resident |
Invariants |
|
Mappings |
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Patient.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Patient.meta | |
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. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
|
Mappings |
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Patient.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Invariants |
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Mappings |
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Patient.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants |
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Mappings |
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Patient.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants |
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Mappings |
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Patient.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Mappings |
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Patient.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.extension:birthPlace | |
Definition | The registered place of birth of the patient. |
Cardinality | 0...1 |
Type | Extension(Address) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
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Patient.extension:birthPlace.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.extension:birthPlace.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.extension:birthPlace.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthPlace |
Mappings |
|
Patient.extension:birthPlace.value[x] | |
Definition | Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list). |
Cardinality | 1...1 |
Type | Address |
Invariants |
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Mappings |
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Patient.extension:birthSex | |
Definition | The patient's phenotypic sex at birth. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:cadavericDonor | |
Definition | Flag indicating whether the patient authorized the donation of body parts after death. |
Cardinality | 0...1 |
Type | Extension(boolean) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:cadavericDonor.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.extension:cadavericDonor.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.extension:cadavericDonor.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor |
Mappings |
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Patient.extension:cadavericDonor.value[x] | |
Definition | Flag indicating whether the patient authorized the donation of body parts after death. |
Cardinality | 1...1 |
Type | boolean |
Invariants |
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Mappings |
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Patient.extension:contactPreference | |
Definition | The preferred method of contact, contact times and written communication format given by a Patient or Related Person. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:deathNotificationStatus | |
Definition | The patient's death notification status. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:ethnicCategory | |
Definition | The ethnicity of the subject. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:fetalStatus | |
Definition | Typically used in maternity where the patient record may be created before the birth of the baby. |
Cardinality | 0...1 |
Type | Extension(code) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:residentialStatus | |
Definition | The residential status of the patient. For example if this patient is a UK resident. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.extension:patientInterpreterRequired | |
Definition | This Patient requires an interpreter to communicate healthcare information to the practitioner. |
Cardinality | 0...1 |
Type | Extension(boolean) |
Alias | extensions, user content |
Comments | The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. |
Invariants |
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Mappings |
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Patient.extension:patientInterpreterRequired.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.extension:patientInterpreterRequired.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.extension:patientInterpreterRequired.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired |
Mappings |
|
Patient.extension:patientInterpreterRequired.value[x] | |
Definition | Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner. |
Cardinality | 1...1 |
Type | boolean |
Invariants |
|
Mappings |
|
Patient.extension:nhsNumberUnavailableReason | |
Definition | The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
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Patient.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.identifier | |
Definition | An identifier for this patient. |
Cardinality | 0...* |
Type | Identifier |
Must Support | True |
Summary | True |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Slicing | Unordered, Open, by system(Value) |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber | |
Definition | An identifier for this patient. |
Cardinality | 0...1 |
Type | Identifier |
Summary | True |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.identifier:nhsNumber.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus | |
Definition | The verification/tracing status of the NHS number. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.use | |
Definition | The purpose of this identifier. |
Cardinality | 0...1 |
Type | code |
Binding | Identifies the purpose for this identifier, if known . |
Modifier | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
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. |
Invariants |
|
Fixed Value | https://fhir.nhs.uk/Id/nhs-number |
Mappings |
|
Patient.identifier:nhsNumber.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Cardinality | 1...1 |
Type | string |
Summary | True |
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. |
Invariants |
|
Examples | General 123456 |
Mappings |
|
Patient.identifier:nhsNumber.period | |
Definition | Time period during which identifier is/was valid for use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.identifier:nhsNumber.assigner | |
Definition | Organization that issued/manages the identifier. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.active | |
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. |
Cardinality | 0...1 |
Type | boolean |
Must Support | True |
Modifier | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.name | |
Definition | A name associated with the individual. |
Cardinality | 0...* |
Type | HumanName |
Must Support | True |
Summary | True |
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name. |
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. |
Invariants |
|
Mappings |
|
Patient.telecom | |
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. |
Cardinality | 0...* |
Type | ContactPoint |
Must Support | True |
Summary | True |
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). |
Invariants |
|
Mappings |
|
Patient.telecom.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.telecom.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.telecom.system | |
Definition | Telecommunications form for contact point - what communications system is required to make use of the contact. |
Cardinality | 0...1 |
Type | code |
Binding | Telecommunications form for contact point. |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Mappings |
|
Patient.telecom.system.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.telecom.system.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.telecom.system.extension:otherContactSystem | |
Definition | Other contact system value which extends the system element in the ContactPoint datatype. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
|
Patient.telecom.system.value | |
Definition | Primitive value for code |
Cardinality | 0...1 |
Type | System.String |
Patient.telecom.value | |
Definition | The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | Need to support legacy numbers that are not in a tightly controlled format. |
Comments | Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. |
Invariants |
|
Mappings |
|
Patient.telecom.use | |
Definition | Identifies the purpose for the contact point. |
Cardinality | 0...1 |
Type | code |
Binding | Use of contact point. |
Modifier | True |
Summary | True |
Requirements | Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. |
Comments | Applications can assume that a contact is current unless it explicitly says that it is temporary or old. |
Invariants |
|
Mappings |
|
Patient.telecom.rank | |
Definition | Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. |
Cardinality | 0...1 |
Type | positiveInt |
Summary | True |
Comments | Note that rank does not necessarily follow the order in which the contacts are represented in the instance. |
Invariants |
|
Mappings |
|
Patient.telecom.period | |
Definition | Time period when the contact point was/is in use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.gender | |
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. |
Cardinality | 0...1 |
Type | code |
Binding | The gender of a person used for administrative purposes. |
Must Support | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.birthDate | |
Definition | The date of birth for the individual. |
Cardinality | 0...1 |
Type | date |
Must Support | True |
Summary | True |
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). |
Invariants |
|
Mappings |
|
Patient.birthDate.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.birthDate.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.birthDate.extension:birthTime | |
Definition | The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. |
Cardinality | 0...1 |
Type | Extension(dateTime) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
|
Patient.birthDate.extension:birthTime.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.birthDate.extension:birthTime.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.birthDate.extension:birthTime.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthTime |
Mappings |
|
Patient.birthDate.extension:birthTime.value[x] | |
Definition | The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. |
Cardinality | 1...1 |
Type | dateTime |
Invariants |
|
Mappings |
|
Patient.birthDate.value | |
Definition | Primitive value for date |
Cardinality | 0...1 |
Type | System.Date |
Patient.deceased[x] | |
Definition | Indicates if the individual is deceased or not. |
Cardinality | 0...1 |
Type | boolean |
Modifier | True |
Summary | True |
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. |
Invariants |
|
Mappings |
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Patient.address | |
Definition | An address for the individual. |
Cardinality | 0...* |
Type | Address |
Must Support | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Patient.address.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.address.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
Patient.address.extension:addressKey | |
Definition | A patient's address key and type. |
Cardinality | 0...* |
Type | Extension(Complex) |
Alias | extensions, user content |
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. |
Invariants |
|
Mappings |
|
Patient.address.use | |
Definition | The purpose of this address. |
Cardinality | 0...1 |
Type | code |
Binding | The use of an address. |
Modifier | True |
Summary | True |
Requirements | Allows an appropriate address to be chosen from a list of many. |
Comments | Applications can assume that an address is current unless it explicitly says that it is temporary or old. |
Invariants |
|
Examples | General home |
Mappings |
|
Patient.address.type | |
Definition | Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. |
Cardinality | 0...1 |
Type | code |
Binding | The type of an address (physical / postal). |
Summary | True |
Comments | The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). |
Invariants |
|
Examples | General both |
Mappings |
|
Patient.address.text | |
Definition | Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | A renderable, unencoded form. |
Comments | Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. |
Invariants |
|
Examples | General 137 Nowhere Street, Erewhon 9132 |
Mappings |
|
Patient.address.line | |
Definition | This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. |
Cardinality | 0...* |
Type | string |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Examples | General 137 Nowhere Street |
Mappings |
|
Patient.address.city | |
Definition | The name of the city, town, suburb, village or other community or delivery center. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Alias | Municpality |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Examples | General Erewhon |
Mappings |
|
Patient.address.district | |
Definition | The name of the administrative area (county). |
Cardinality | 0...1 |
Type | string |
Summary | True |
Alias | County |
Comments | District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. |
Invariants |
|
Examples | General Madison |
Mappings |
|
Patient.address.state | |
Definition | Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). |
Cardinality | 0...1 |
Type | string |
Summary | True |
Alias | Province, Territory |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Mappings |
|
Patient.address.postalCode | |
Definition | A postal code designating a region defined by the postal service. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Alias | Zip |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Examples | General 9132 |
Mappings |
|
Patient.address.country | |
Definition | Country - a nation as commonly understood or generally accepted. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | ISO 3166 3 letter codes can be used in place of a human readable country name. |
Invariants |
|
Mappings |
|
Patient.address.period | |
Definition | Time period when address was/is in use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
Requirements | Allows addresses 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. |
Invariants |
|
Examples | General { "start": "2010-03-23", "end": "2010-07-01" } |
Mappings |
|
Patient.maritalStatus | |
Definition | This field contains a patient's most recent marital (civil) status. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | An indicator to identify the legal marital status of a person |
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. |
Invariants |
|
Mappings |
|
Patient.multipleBirth[x] | |
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). |
Cardinality | 0...1 |
Type | boolean |
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). |
Invariants |
|
Mappings |
|
Patient.photo | |
Definition | Image of the patient. |
Cardinality | 0...* |
Type | Attachment |
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. |
Comments | Guidelines:
|
Invariants |
|
Mappings |
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Patient.contact | |
Definition | A contact party (e.g. guardian, partner, friend) for the patient. |
Cardinality | 0...* |
Type | BackboneElement |
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. |
Invariants |
|
Mappings |
|
Patient.contact.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
Patient.contact.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.contact.extension:contactRank | |
Definition | The preferred ranking or order of contact applied to a contact on a patient's contact list. |
Cardinality | 0...1 |
Type | Extension(positiveInt) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.contact.extension:copyCorrespondenceIndicator | |
Definition | Extension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence. |
Cardinality | 0...1 |
Type | Extension(boolean) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.contact.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Patient.contact.relationship | |
Definition | The nature of the relationship between the patient and the contact person. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The nature of the relationship between a patient and a contact person for that patient. |
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances. |
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. |
Invariants |
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Mappings |
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Patient.contact.name | |
Definition | A name associated with the contact person. |
Cardinality | 0...1 |
Type | HumanName |
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. |
Invariants |
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Mappings |
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Patient.contact.telecom | |
Definition | A contact detail for the person, e.g. a telephone number or an email address. |
Cardinality | 0...* |
Type | ContactPoint |
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. |
Invariants |
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Mappings |
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Patient.contact.telecom.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.contact.telecom.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.contact.telecom.system | |
Definition | Telecommunications form for contact point - what communications system is required to make use of the contact. |
Cardinality | 0...1 |
Type | code |
Binding | Telecommunications form for contact point. |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Patient.contact.telecom.system.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.contact.telecom.system.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.contact.telecom.system.extension:otherContactSystem | |
Definition | Other contact system value which extends the system element in the ContactPoint datatype. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.contact.telecom.system.value | |
Definition | Primitive value for code |
Cardinality | 0...1 |
Type | System.String |
Patient.contact.telecom.value | |
Definition | The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | Need to support legacy numbers that are not in a tightly controlled format. |
Comments | Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. |
Invariants |
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Mappings |
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Patient.contact.telecom.use | |
Definition | Identifies the purpose for the contact point. |
Cardinality | 0...1 |
Type | code |
Binding | Use of contact point. |
Modifier | True |
Summary | True |
Requirements | Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. |
Comments | Applications can assume that a contact is current unless it explicitly says that it is temporary or old. |
Invariants |
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Mappings |
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Patient.contact.telecom.rank | |
Definition | Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. |
Cardinality | 0...1 |
Type | positiveInt |
Summary | True |
Comments | Note that rank does not necessarily follow the order in which the contacts are represented in the instance. |
Invariants |
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Mappings |
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Patient.contact.telecom.period | |
Definition | Time period when the contact point was/is in use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
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. |
Invariants |
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Mappings |
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Patient.contact.address | |
Definition | Address for the contact person. |
Cardinality | 0...1 |
Type | Address |
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). |
Invariants |
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Mappings |
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Patient.contact.gender | |
Definition | Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. |
Cardinality | 0...1 |
Type | code |
Binding | The gender of a person used for administrative purposes. |
Requirements | Needed to address the person correctly. |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Patient.contact.organization | |
Definition | Organization on behalf of which the contact is acting or for which the contact is working. |
Cardinality | 0...1 |
Type | Reference(Organization) |
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. |
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Mappings |
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Patient.contact.period | |
Definition | The period during which this contact person or organization is valid to be contacted relating to this patient. |
Cardinality | 0...1 |
Type | Period |
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. |
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Mappings |
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Patient.communication | |
Definition | A language which may be used to communicate with the patient about his or her health. |
Cardinality | 0...* |
Type | BackboneElement |
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. |
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Mappings |
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Patient.communication.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.communication.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency | |
Definition | Proficiency level of the communication. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.communication.extension:proficiency.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:level | |
Definition | How well the patient can communicate this communication (good, poor, etc.). |
Cardinality | 0...1 |
Type | Extension |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:level.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.communication.extension:proficiency.extension:level.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:level.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | level |
Mappings |
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Patient.communication.extension:proficiency.extension:level.value[x] | |
Definition | The proficiency level for the communication. |
Cardinality | 1...1 |
Type | Coding |
Binding | The proficiency level for the communication. |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:type | |
Definition | What type of communication for the proficiency (spoken, written, etc.). |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:type.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.communication.extension:proficiency.extension:type.extension | |
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. |
Cardinality | 0...0 |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.extension:type.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | type |
Mappings |
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Patient.communication.extension:proficiency.extension:type.value[x] | |
Definition | The proficiency type for the communication. |
Cardinality | 1...1 |
Type | Coding |
Binding | The proficiency type for the communication. |
Invariants |
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Mappings |
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Patient.communication.extension:proficiency.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Cardinality | 1...1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-proficiency |
Mappings |
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Patient.communication.extension:proficiency.value[x] | |
Definition | Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list). |
Cardinality | 0...0 |
Type | base64Binary |
Invariants |
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Mappings |
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Patient.communication.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Patient.communication.language | |
Definition | A ValueSet that identifies the language used by a person. |
Cardinality | 1...1 |
Type | CodeableConcept |
Binding | A ValueSet that identifies the language used by a person. |
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. |
Invariants |
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Mappings |
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Patient.communication.preferred | |
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). |
Cardinality | 0...1 |
Type | boolean |
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. |
Invariants |
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Mappings |
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Patient.generalPractitioner | |
Definition | Patient's nominated care provider. |
Cardinality | 0...* |
Type | Reference(Organization | Practitioner | PractitionerRole) |
Alias | careProvider |
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. |
Invariants |
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Mappings |
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Patient.managingOrganization | |
Definition | Organization that is the custodian of the patient record. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Must Support | True |
Summary | True |
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). |
Invariants |
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Mappings |
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Patient.link | |
Definition | Link to another patient resource that concerns the same actual patient. |
Cardinality | 0...* |
Type | BackboneElement |
Modifier | True |
Summary | True |
Requirements | There are multiple use cases:
|
Comments | There is no assumption that linked patient records have mutual links. |
Invariants |
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Mappings |
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Patient.link.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Patient.link.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Patient.link.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Patient.link.other | |
Definition | The other patient resource that the link refers to. |
Cardinality | 1...1 |
Type | Reference(Patient | RelatedPerson) |
Summary | True |
Comments | Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. |
Invariants |
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Mappings |
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Patient.link.type | |
Definition | The type of link between this patient resource and another patient resource. |
Cardinality | 1...1 |
Type | code |
Binding | The type of link between this patient resource and another patient resource. |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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FHIR | MDS | HL7v2 |
---|---|---|
Patient.identifier | Patient - NHS number, Patient - Local identifier, Patient - Pedigree/Family Identifier, Fetus - Local identifier, Previous genomic report - Patient's NHS number, Previous genomic report - Patient's alternative identifier, Previous genomic report - Patient's clinical genetics number, Previous genomic report - Patient's pedigree number | PID-3 |
Patient.extension:nhsNumberUnavailableReason | Patient - Reason for unavailable NHS number, Patient - Withheld identity reason | N/A, could use PID-32 as surrogate |
Patient.name.prefix | Patient - Title | PID-5.5 |
Patient.name.given | Patient - First name, Previous genomic report - Patient's first name | PID-5.2 |
Patient.name.family | Patient - Surname, Previous genomic report - Patient's surname | PID-5.1 |
Patient.birthDate | Patient - Date of birth, PLCM activity - Patient age at activity date, Previous genomic report - Patient's date of birth | PID-7, Age derived from the difference between PID-7 and TQ1-7 for the relevant activity |
Patient.address | Patient - Address, Previous genomic report - Patient's address | PID-11 |
Patient.address.postalCode | Patient - Postcode, Previous genomic report - Patient's post code | PID-11.5 |
Patient.address.country | Patient - Country, Previous genomic report - Patient's country | PID-11.6 |
Patient.deceasedBoolean | Patient - Life status at time of request | PID-30 |
Patient.deceasedDateTime | Patient - Date of death | PID-29 |
Patient.extension:EthnicCategory | Patient - Ethnicity | PID-22 |
Patient.extension:birthSex | Patient - Sex assigned at birth | PID-8 |
Patient.extension:patient-genderIdentity | Patient - Gender Identity | N/A - not part of the HL7v2 standard, though PID-8 or an OBX segment could be used |
Patient.generalPractitioner | Patient - GP Practice ODS Code, Patient - GP full name, Patient - GP GMC number | PD1-4 |
Patient.gender | Fetus - Observed sex | PID-8 |
Constraint Profiles
Profiles indicating preferred element cardinality for use in Genomics, not to be used for validation
name | profile |
---|---|
NHSDigital_Patient_Genomics | https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient-Genomics |
Additional Guidance
extension:UKCore-birthSex
Extension used for recording the phenotypic sex of the patient, as recorded at birth.
{ "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex", "valueCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-AdministrativeGender", "code": "M", "display": "Male" } ] } }
identifier
SHALL be present for Patients within the Genomic Order Management ecosystem. It is preferred that all patients with an NHS number have this included within the Patient resource upon submission of a test order. Patient who do not have an NHS number SHOULD have a temporary one registered/assigned with PDS.
For patient records where the NHS number has been traced from PDS, the trace status SHOULD be provided within the NHS Number identifier slice.
Additional identifiers SHOULD include an appropriate naming system scheme which clearly identifies the assigner (to disambiguate the identifier from other resources where these are not nationally unique). Alternatively, the OID for local identifier MAY be used, with the 'assigner' organization explicitly referenced.
"identifier": [ { "system": "https://fhir.nhs.uk/Id/nhs-number", "value": "9449307946", "extension": [ { "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus", "valueCodeableConcept": { "coding": [ { "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland", "version": "2.2.0", "code": "01", "display": "Number present and verified" } ] } } ] }, { "system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24", "value": "RWT14789", "assigner": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "RAX01" } } } ],
generalPractitioner
Where patients are registered with a General Practitioner within the UK, both the ODS code for the practice and GMP number for the practitioner SHOULD be provided, where known, as separate objects within the generalPractitioner array.
"generalPractitioner": [ { "identifier": { "system": "https://fhir.hl7.org.uk/Id/gmp-number", "value": "G9999999" }, "display": "Dr. Aero Smith" }, { "identifier": { "system": "https://fhir.hl7.org.uk/Id/ODS-code", "value": "AP123" }, "display": "anywhere place" } ],
link
For patient records where additional information exists elsewhere, for example, within PDS or the source system EHR, this MAY be referenced through the link field, specifying the url through which the related patient information can be accessed.
"link": [ { "other": { "reference": "https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449307946" }, "type": "seealso" } ]