| TrainingPatient (Patient) | I | | Patient | There are no (further) constraints on this element Element idShort description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Patient Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists() - dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()
- rim: Entity. Role, or Act
- rim: Patient[classCode=PAT]
- cda: ClinicalDocument.recordTarget.patientRole
|
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
string |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idShort description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Meta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idShort description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description Language of the resource content Definition The base language in which the resource is written.
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).
code Binding CommonLanguages (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| text | | 0..1 | Narrative | There are no (further) constraints on this element Element idShort description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
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.
Narrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: N/A
- rim: Act.text?
|
| contained | | 0..* | Resource | There are no (further) constraints on this element Element idShort description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
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.
Resource Mappings- rim: Entity. Role, or Act
- rim: N/A
|
| extension | I | 0..* | ExtensionBinding | Element idShort description occupation Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Binding http://www.alpha-hospital.alp/occupations (extensible)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| myExtension | I | 0..* | Extension | Element idPatient.extension:myExtension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Extension URL https://example.org/fhir/StructureDefinition/MyExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.extension:myExtension.id Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.extension:myExtension.extension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| beroepsCode | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.extension:myExtension.extension:beroepsCode Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idPatient.extension:myExtension.extension:beroepsCode.id Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.extension:myExtension.extension:beroepsCode.extension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| url | | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.extension:myExtension.extension:beroepsCode.url identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL.
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.
uri Fixed value Mappings |
| value[x] | | 0..1 | Binding | Element idPatient.extension:myExtension.extension:beroepsCode.value[x] Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| valueBase64Binary | | | base64Binary | There are no (further) constraints on this element Data type base64Binary |
| valueBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
| valueCanonical | | | canonical() | There are no (further) constraints on this element Data type canonical() |
| valueCode | | | code | There are no (further) constraints on this element Data type code |
| valueDate | | | date | There are no (further) constraints on this element Data type date |
| valueDateTime | | | dateTime | There are no (further) constraints on this element Data type dateTime |
| valueDecimal | | | decimal | There are no (further) constraints on this element Data type decimal |
| valueId | | | id | There are no (further) constraints on this element Data type id |
| valueInstant | | | instant | There are no (further) constraints on this element Data type instant |
| valueInteger | | | integer | There are no (further) constraints on this element Data type integer |
| valueMarkdown | | | markdown | There are no (further) constraints on this element Data type markdown |
| valueOid | | | oid | There are no (further) constraints on this element Data type oid |
| valuePositiveInt | | | positiveInt | There are no (further) constraints on this element Data type positiveInt |
| valueString | | | string | There are no (further) constraints on this element Data type string |
| valueTime | | | time | There are no (further) constraints on this element Data type time |
| valueUnsignedInt | | | unsignedInt | There are no (further) constraints on this element Data type unsignedInt |
| valueUri | | | uri | There are no (further) constraints on this element Data type uri |
| valueUrl | | | url | There are no (further) constraints on this element Data type url |
| valueUuid | | | uuid | There are no (further) constraints on this element Data type uuid |
| valueAddress | | | Address | There are no (further) constraints on this element Data type Address |
| valueAge | | | Age | There are no (further) constraints on this element Data type Age |
| valueAnnotation | | | Annotation | There are no (further) constraints on this element Data type Annotation |
| valueAttachment | | | Attachment | There are no (further) constraints on this element Data type Attachment |
| valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data type CodeableConcept |
| valueCoding | | | Coding | There are no (further) constraints on this element Data type Coding |
| valueContactPoint | | | ContactPoint | There are no (further) constraints on this element Data type ContactPoint |
| valueCount | | | Count | There are no (further) constraints on this element Data type Count |
| valueDistance | | | Distance | There are no (further) constraints on this element Data type Distance |
| valueDuration | | | Duration | There are no (further) constraints on this element Data type Duration |
| valueHumanName | | | HumanName | There are no (further) constraints on this element Data type HumanName |
| valueIdentifier | | | Identifier | There are no (further) constraints on this element Data type Identifier |
| valueMoney | | | Money | There are no (further) constraints on this element Data type Money |
| valuePeriod | | | Period | There are no (further) constraints on this element Data type Period |
| valueQuantity | | | Quantity | There are no (further) constraints on this element Data type Quantity |
| valueRange | | | Range | There are no (further) constraints on this element Data type Range |
| valueRatio | | | Ratio | There are no (further) constraints on this element Data type Ratio |
| valueSampledData | | | SampledData | There are no (further) constraints on this element Data type SampledData |
| valueSignature | | | Signature | There are no (further) constraints on this element Data type Signature |
| valueTiming | | | Timing | There are no (further) constraints on this element Data type Timing |
| valueContactDetail | | | ContactDetail | There are no (further) constraints on this element Data type ContactDetail |
| valueContributor | | | Contributor | There are no (further) constraints on this element Data type Contributor |
| valueDataRequirement | | | DataRequirement | There are no (further) constraints on this element Data type DataRequirement |
| valueExpression | | | Expression | There are no (further) constraints on this element Data type Expression |
| valueParameterDefinition | | | ParameterDefinition | There are no (further) constraints on this element Data type ParameterDefinition |
| valueRelatedArtifact | | | RelatedArtifact | There are no (further) constraints on this element Data type RelatedArtifact |
| valueTriggerDefinition | | | TriggerDefinition | There are no (further) constraints on this element Data type TriggerDefinition |
| valueUsageContext | | | UsageContext | There are no (further) constraints on this element Data type UsageContext |
| valueDosage | | | Dosage | There are no (further) constraints on this element Data type Dosage |
| valueMeta | | | Meta | There are no (further) constraints on this element Data type Meta |
| valueReference | | | Reference() | There are no (further) constraints on this element Data type Reference() |
| url | | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.extension:myExtension.url identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL.
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.
uri Fixed value https://example.org/fhir/StructureDefinition/MyExtension |
| value[x] | | 0..1 | | There are no (further) constraints on this element Element idPatient.extension:myExtension.value[x] Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| valueBase64Binary | | | base64Binary | There are no (further) constraints on this element Data type base64Binary |
| valueBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
| valueCanonical | | | canonical() | There are no (further) constraints on this element Data type canonical() |
| valueCode | | | code | There are no (further) constraints on this element Data type code |
| valueDate | | | date | There are no (further) constraints on this element Data type date |
| valueDateTime | | | dateTime | There are no (further) constraints on this element Data type dateTime |
| valueDecimal | | | decimal | There are no (further) constraints on this element Data type decimal |
| valueId | | | id | There are no (further) constraints on this element Data type id |
| valueInstant | | | instant | There are no (further) constraints on this element Data type instant |
| valueInteger | | | integer | There are no (further) constraints on this element Data type integer |
| valueMarkdown | | | markdown | There are no (further) constraints on this element Data type markdown |
| valueOid | | | oid | There are no (further) constraints on this element Data type oid |
| valuePositiveInt | | | positiveInt | There are no (further) constraints on this element Data type positiveInt |
| valueString | | | string | There are no (further) constraints on this element Data type string |
| valueTime | | | time | There are no (further) constraints on this element Data type time |
| valueUnsignedInt | | | unsignedInt | There are no (further) constraints on this element Data type unsignedInt |
| valueUri | | | uri | There are no (further) constraints on this element Data type uri |
| valueUrl | | | url | There are no (further) constraints on this element Data type url |
| valueUuid | | | uuid | There are no (further) constraints on this element Data type uuid |
| valueAddress | | | Address | There are no (further) constraints on this element Data type Address |
| valueAge | | | Age | There are no (further) constraints on this element Data type Age |
| valueAnnotation | | | Annotation | There are no (further) constraints on this element Data type Annotation |
| valueAttachment | | | Attachment | There are no (further) constraints on this element Data type Attachment |
| valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data type CodeableConcept |
| valueCoding | | | Coding | There are no (further) constraints on this element Data type Coding |
| valueContactPoint | | | ContactPoint | There are no (further) constraints on this element Data type ContactPoint |
| valueCount | | | Count | There are no (further) constraints on this element Data type Count |
| valueDistance | | | Distance | There are no (further) constraints on this element Data type Distance |
| valueDuration | | | Duration | There are no (further) constraints on this element Data type Duration |
| valueHumanName | | | HumanName | There are no (further) constraints on this element Data type HumanName |
| valueIdentifier | | | Identifier | There are no (further) constraints on this element Data type Identifier |
| valueMoney | | | Money | There are no (further) constraints on this element Data type Money |
| valuePeriod | | | Period | There are no (further) constraints on this element Data type Period |
| valueQuantity | | | Quantity | There are no (further) constraints on this element Data type Quantity |
| valueRange | | | Range | There are no (further) constraints on this element Data type Range |
| valueRatio | | | Ratio | There are no (further) constraints on this element Data type Ratio |
| valueSampledData | | | SampledData | There are no (further) constraints on this element Data type SampledData |
| valueSignature | | | Signature | There are no (further) constraints on this element Data type Signature |
| valueTiming | | | Timing | There are no (further) constraints on this element Data type Timing |
| valueContactDetail | | | ContactDetail | There are no (further) constraints on this element Data type ContactDetail |
| valueContributor | | | Contributor | There are no (further) constraints on this element Data type Contributor |
| valueDataRequirement | | | DataRequirement | There are no (further) constraints on this element Data type DataRequirement |
| valueExpression | | | Expression | There are no (further) constraints on this element Data type Expression |
| valueParameterDefinition | | | ParameterDefinition | There are no (further) constraints on this element Data type ParameterDefinition |
| valueRelatedArtifact | | | RelatedArtifact | There are no (further) constraints on this element Data type RelatedArtifact |
| valueTriggerDefinition | | | TriggerDefinition | There are no (further) constraints on this element Data type TriggerDefinition |
| valueUsageContext | | | UsageContext | There are no (further) constraints on this element Data type UsageContext |
| valueDosage | | | Dosage | There are no (further) constraints on this element Data type Dosage |
| valueMeta | | | Meta | There are no (further) constraints on this element Data type Meta |
| valueReference | | | Reference() | There are no (further) constraints on this element Data type Reference() |
| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.modifierExtension Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idShort description An identifier for this patient Definition An identifier for this patient.
Patients are almost always assigned specific numerical identifiers.
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- w5: FiveWs.identifier
- v2: PID-3
- rim: id
- cda: .id
|
| active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idShort description Whether this patient's record is in active use Definition Whether this patient record is in active use.
Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.
It is often used to filter patient lists to exclude inactive patients
Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Need to be able to mark a patient record as not to be used because it was created in error.
If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
This resource is generally assumed to be active if no value is provided for the active element
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- w5: FiveWs.status
- rim: statusCode
- cda: n/a
|
| name | S Σ | 1..1 | HumanName | There are no (further) constraints on this element Element idShort description A name associated with the patient Definition A name associated with the individual.
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
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.
HumanName Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN
- rim: EN (actually, PN)
- servd: ProviderName
- v2: PID-5, PID-9
- rim: name
- cda: .patient.name
|
| telecom | Σ I | 0..* | ContactPoint | There are no (further) constraints on this element Element idShort description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
People have (primary) ways to contact them in some way such as phone, email.
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).
ContactPoint Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
- rim: n/a
- v2: XTN
- rim: TEL
- servd: ContactPoint
- v2: PID-13, PID-14, PID-40
- rim: telecom
- cda: .telecom
|
| gender | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description male | female | other | unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Needed for identification of the individual, in combination with (at least) name and birth date.
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.
code Binding The gender of a person used for administrative purposes.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-8
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- cda: .patient.administrativeGenderCode
|
| birthDate | Σ | 0..1 | date | There are no (further) constraints on this element Element idShort description The date of birth for the individual Definition The date of birth for the individual.
Age of the individual drives many clinical processes.
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).
date Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-7
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
- cda: .patient.birthTime
- loinc: 21112-8
|
| deceased[x] | Σ ?! | 0..1 | | There are no (further) constraints on this element Element idShort description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not.
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.
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-30 (bool) and PID-29 (datetime)
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
- cda: n/a
|
| deceasedBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
| deceasedDateTime | | | dateTime | There are no (further) constraints on this element Data type dateTime |
| address | Σ I | 0..* | Address | Element idShort description An address for the individual Definition An address for the individual.
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Patient may have multiple addresses with different uses or applicable periods.
Address Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - training-2: Temporary adress, but period is not filled in
(use = 'temp') implies period.exists()
- rim: n/a
- v2: XAD
- rim: AD
- servd: Address
- v2: PID-11
- rim: addr
- cda: .addr
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idShort description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.address.extension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| use | Σ ?! I | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description home | work | temp | old | billing - purpose of this address Definition The purpose of this address.
Allows an appropriate address to be chosen from a list of many.
Applications can assume that an address is current unless it explicitly says that it is temporary or old.
code Binding AddressUse (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.7
- rim: unique(./use)
- servd: ./AddressPurpose
|
| type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description postal | physical | both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.
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).
code Binding The type of an address (physical / postal).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.18
- rim: unique(./use)
- vcard: address type parameter
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
A renderable, unencoded form.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
General137 Nowhere Street, Erewhon 9132
Mappings- rim: n/a
- v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
- rim: ./formatted
- vcard: address label parameter
|
| line | Σ | 0..* | string | There are no (further) constraints on this element Element idShort description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Note that FHIR strings SHALL NOT exceed 1MB in size
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
General137 Nowhere Street
Mappings- rim: n/a
- v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
- rim: AD.part[parttype = AL]
- vcard: street
- servd: ./StreetAddress (newline delimitted)
|
| city | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center.
Note that FHIR strings SHALL NOT exceed 1MB in size
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.3
- rim: AD.part[parttype = CTY]
- vcard: locality
- servd: ./Jurisdiction
|
| district | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description District name (aka county) Alternate names County Definition The name of the administrative area (county).
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.9
- rim: AD.part[parttype = CNT | CPA]
|
| state | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Sub-unit of country (abbreviations ok) Alternate names Province, Territory 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).
Note that FHIR strings SHALL NOT exceed 1MB in size
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XAD.4
- rim: AD.part[parttype = STA]
- vcard: region
- servd: ./Region
|
| postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.postalCode Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service.
Note that FHIR strings SHALL NOT exceed 1MB in size
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: XAD.5
- rim: AD.part[parttype = ZIP]
- vcard: code
- servd: ./PostalIdentificationCode
|
| country | Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted.
ISO 3166 3 letter codes can be used in place of a human readable country name.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XAD.6
- rim: AD.part[parttype = CNT]
- vcard: country
- servd: ./Country
|
| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idShort description Time period when address was/is in use Definition Time period when address was/is in use.
Allows addresses to be placed in historical context.
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.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
General{
"start": "2010-03-23",
"end": "2010-07-01"
}
Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: XAD.12 / XAD.13 + XAD.14
- rim: ./usablePeriod[type="IVL<TS>"]
- servd: ./StartDate and ./EndDate
|
| maritalStatus | | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idShort description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status.
Most, if not all systems capture it.
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.
CodeableConcept Binding The domestic partnership status of a person.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: PID-16
- rim: player[classCode=PSN]/maritalStatusCode
- cda: .patient.maritalStatusCode
|
| multipleBirth[x] | | 0..1 | | There are no (further) constraints on this element Element idShort description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
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).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-24 (bool), PID-25 (integer)
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
- cda: n/a
|
| multipleBirthBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
| multipleBirthInteger | | | integer | There are no (further) constraints on this element Data type integer |
| photo | I | 0..* | Attachment | There are no (further) constraints on this element Element idShort description Image of the patient Definition Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Guidelines:
- Use id photos, not clinical photos.
- Limit dimensions to thumbnail.
- Keep byte count low to ease resource updates.
Attachment Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - att-1: If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()
- rim: n/a
- v2: ED/RP
- rim: ED
- v2: OBX-5 - needs a profile
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
- cda: n/a
|
| contact | I | 0..* | BackboneElement | There are no (further) constraints on this element Element idShort description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient.
Need to track people you can contact about the patient.
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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - pat-1: SHALL at least contain a contact's details or a reference to an organization
name.exists() or telecom.exists() or address.exists() or organization.exists()
- rim: n/a
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
- cda: n/a
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idShort description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.extension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| relationship | | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.contact.relationship The kind of relationship Definition The nature of the relationship between the patient and the contact person.
Used to determine which contact person is the most relevant to approach, depending on circumstances.
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.
CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: NK1-7, NK1-3
- rim: code
- cda: n/a
|
| name | | 0..1 | HumanName | There are no (further) constraints on this element Element idShort description A name associated with the contact person Definition A name associated with the contact person.
Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
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.
HumanName Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XPN
- rim: EN (actually, PN)
- servd: ProviderName
- v2: NK1-2
- rim: name
- cda: n/a
|
| telecom | I | 0..* | ContactPoint | There are no (further) constraints on this element Element idShort description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address.
People have (primary) ways to contact them in some way such as phone, email.
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.
ContactPoint Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - cpt-2: A system is required if a value is provided.
value.empty() or system.exists()
- rim: n/a
- v2: XTN
- rim: TEL
- servd: ContactPoint
- v2: NK1-5, NK1-6, NK1-40
- rim: telecom
- cda: n/a
|
| address | | 0..1 | Address | There are no (further) constraints on this element Element idShort description Address for the contact person Definition Address for the contact person.
Need to keep track where the contact person can be contacted per postal mail or visited.
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).
Address Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: XAD
- rim: AD
- servd: Address
- v2: NK1-4
- rim: addr
- cda: n/a
|
| gender | | 0..1 | codeBinding | There are no (further) constraints on this element Element idShort description male | female | other | unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Needed to address the person correctly.
Note that FHIR strings SHALL NOT exceed 1MB in size
code Binding The gender of a person used for administrative purposes.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: NK1-15
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
- cda: n/a
|
| organization | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.contact.organization Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working.
For guardians or business related contacts, the organization is relevant.
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.
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
- rim: scoper
- cda: n/a
|
| period | I | 0..1 | Period | There are no (further) constraints on this element Element idShort description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient.
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.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- rim: effectiveTime
- cda: n/a
|
| communication | | 0..* | BackboneElement | There are no (further) constraints on this element Element idShort description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health.
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.
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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: LanguageCommunication
- cda: patient.languageCommunication
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idShort description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.extension Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
| language | | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.communication.language The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
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.
CodeableConcept Binding CommonLanguages (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: PID-15, LAN-2
- rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
- cda: .languageCode
|
| preferred | | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.communication.preferred Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
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.
This language is specifically identified for communicating healthcare information.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- v2: PID-15
- rim: preferenceInd
- cda: .preferenceInd
|
| generalPractitioner | I | 0..* | Reference(Organization | Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idPatient.generalPractitioner Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider.
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.
Reference(Organization | Practitioner | PractitionerRole) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: PD1-4
- rim: subjectOf.CareEvent.performer.AssignedEntity
- cda: n/a
|
| managingOrganization | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.managingOrganization Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record.
Need to know who recognizes this patient record, manages and updates it.
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).
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: scoper
- cda: .providerOrganization
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| link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element idShort description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient.
There are multiple use cases:
- Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
- Distribution of patient information across multiple servers.
There is no assumption that linked patient records have mutual links.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: outboundLink
- cda: n/a
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| id | | 0..1 | string | There are no (further) constraints on this element Element idShort description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idShort description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idPatient.link.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
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.
Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
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| other | Σ I | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element idShort description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to.
Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Reference(Patient | RelatedPerson) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: PID-3, MRG-1
- rim: id
- cda: n/a
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| type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idShort description replaced-by | replaces | refer | seealso Definition The type of link between this patient resource and another patient resource.
Note that FHIR strings SHALL NOT exceed 1MB in size
code Binding The type of link between this patient resource and another patient resource.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: n/a
- rim: typeCode
- cda: n/a
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